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1. Predicting Major Adverse Events in Patients With Acute Myocardial Infarction

Author

Hafner, Benjamin, Flores, Dayana, Meissner, Kathrin, Kulangara, Caroline, Freese, Michael, Osswald, Stefan, Stelzig, Claudia, Bingisser, Roland, Fuenzalida Inostroza, Carolina Isabel, Rodríguez Adrada, Esther, Nowalany-Kozielska, Ewa, Kawecki, Damian, Parenica, Jiri, Ganovská, Eva, Lohrmann, Jens, Amrein, Melissa, Steude, Jana, Buser, Andreas, Grimm, Karin, Hartmann, Beate, Morawiec, Beata, Rentsch, Katharina, von Eckardstein, Arnold, Biskup, Ewalina, Campodarve, Isabel, Gea, Joachim, Nestelberger, Thomas, Boeddinghaus, Jasper, Wussler, Desiree, Twerenbold, Raphael, Badertscher, Patrick, Wildi, Karin, Miró, Òscar, López, Beatriz, Martin-Sanchez, F. Javier, Muzyk, Piotr, Koechlin, Luca, Baumgartner, Benjamin, Meier, Mario, Troester, Valentina, Rubini Giménez, Maria, Puelacher, Christian, du Fay de Lavallaz, Jeanne, Walter, Joan, Kozhuharov, Nikola, Zimmermann, Tobias, Gualandro, Danielle M., Michou, Eleni, Potlukova, Eliska, Geigy, Nicolas, Keller, Dagmar I., Reichlin, Tobias, and Mueller, Christian

Published
2019
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2. Diagnostic and prognostic values of the V-index, a novel ECG marker quantifying spatial heterogeneity of ventricular repolarization, in patients with symptoms suggestive of non-ST-elevation myocardial infarction

Author

Abächerli, Roger, Twerenbold, Raphael, Boeddinghaus, Jasper, Nestelberger, Thomas, Mächler, Patrick, Sassi, Roberto, Rivolta, Massimo W, Roonizi, Ebadollah Kheirati, Mainardi, Luca T, Kozhuharov, Nikola, Rubini Giménez, Maria, Wildi, Karin, Grimm, Karin, Sabti, Zaid, Hillinger, Petra, Puelacher, Christian, Strebel, Ivo, Cupa, Janosch, Badertscher, Patrick, Roux, Isabelle, Schmid, Ramun, Leber, Remo, Osswald, Stefan, Mueller, Christian, and Reichlin, Tobias

Published
2017
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5. Characterization of the observe zone of the ESC 2015 high-sensitivity cardiac troponin 0 h/1 h-algorithm for the early diagnosis of acute myocardial infarction

Author

Nestelberger, Thomas, Wildi, Karin, Boeddinghaus, Jasper, Twerenbold, Raphael, Reichlin, Tobias, Giménez, Maria Rubini, Puelacher, Christian, Jaeger, Cedric, Grimm, Karin, Sabti, Zaid, Hillinger, Petra, Kozhuharov, Nikola, du Fay de Lavallaz, Jeanne, Pinck, Florentina, Lopez, Beatriz, Salgado, Emilio, Miró, Òscar, Bingisser, Roland, Lohrmann, Jens, Osswald, Stefan, and Mueller, Christian

Published
2016
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6. Early diagnosis of acute myocardial infarction in patients with mild elevations of cardiac troponin

Author

Boeddinghaus, Jasper, Reichlin, Tobias, Nestelberger, Thomas, Twerenbold, Raphael, Meili, Yvette, Wildi, Karin, Hillinger, Petra, Giménez, Maria Rubini, Cupa, Janosch, Schumacher, Lukas, Schubera, Marie, Badertscher, Patrick, Corbière, Sydney, Grimm, Karin, Puelacher, Christian, Sabti, Zaid, Widmer, Dayana Flores, Schaerli, Nicolas, Kozhuharov, Nikola, Shrestha, Samyut, Bürge, Tobias, Mächler, Patrick, Büchi, Michael, Rentsch, Katharina, Miró, Òscar, López, Beatriz, Martin-Sanchez, F. Javier, Rodriguez-Adrada, Esther, Morawiec, Beata, Kawecki, Damian, Ganovská, Eva, Parenica, Jiri, Lohrmann, Jens, Buser, Andreas, Keller, Dagmar I., Osswald, Stefan, and Mueller, Christian

Published
2017
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7. Gender-specific uncertainties in the diagnosis of acute coronary syndrome

Author

Hillinger, Petra, Twerenbold, Raphael, Wildi, Karin, Rubini Gimenez, Maria, Jaeger, Cedric, Boeddinghaus, Jasper, Nestelberger, Thomas, Grimm, Karin, Reichlin, Tobias, Stallone, Fabio, Puelacher, Christian, Sabti, Zaid, Kozhuharov, Nikola, Honegger, Ursina, Ballarino, Paola, Miro, Oscar, Denhaerynck, Kris, Ekrem, Temizel, Kohler, Claudia, Bingisser, Roland, Osswald, Stefan, and Mueller, Christian

Published
2017
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8. Combining High-Sensitivity Cardiac Troponin I and Cardiac Troponin T in the Early Diagnosis of Acute Myocardial Infarction

Author

van der Linden, Noreen, Wildi, Karin, Twerenbold, Raphael, Pickering, John W., Than, Martin, Cullen, Louise, Greenslade, Jaimi, Parsonage, William, Nestelberger, Thomas, Boeddinghaus, Jasper, Badertscher, Patrick, Rubini Giménez, Maria, Klinkenberg, Lieke J.J., Bekers, Otto, Schöni, Aline, Keller, Dagmar I., Sabti, Zaid, Puelacher, Christian, Cupa, Janosch, Schumacher, Lukas, Kozhuharov, Nikola, Grimm, Karin, Shrestha, Samyut, Flores, Dayana, Freese, Michael, Stelzig, Claudia, Strebel, Ivo, Miró, Òscar, Rentsch, Katharina, Morawiec, Beata, Kawecki, Damian, Kloos, Wanda, Lohrmann, Jens, Richards, A. Mark, Troughton, Richard, Pemberton, Christopher, Osswald, Stefan, van Dieijen-Visser, Marja P., Mingels, Alma M., Reichlin, Tobias, Meex, Steven J.R., and Mueller, Christian

Published
2018
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9. Response by Kaier et al to Letter Regarding Article, “Direct Comparison of Cardiac Myosin-Binding Protein C With Cardiac Troponins for the Early Diagnosis of Acute Myocardial Infarction”

Author

Kaier, Thomas E., Twerenbold, Raphael, Puelacher, Christian, Marjot, Jack, Imambaccus, Nazia, Boeddinghaus, Jasper, Nestelberger, Thomas, Badertscher, Patrick, Sabti, Zaid, Rubini Giménez, Maria, Wildi, Karin, Hillinger, Petra, Grimm, Karin, Loeffel, Sarah, Shrestha, Samyut, Flores Widmer, Dayana, Cupa, Janosch, Kozhuharov, Nikola, Miró, Òscar, Martín-Sánchez, F. Javier, Morawiec, Beata, Rentsch, Katharina, Lohrmann, Jens, Kloos, Wanda, Osswald, Stefan, Reichlin, Tobias, Weber, Ekkehard, Marber, Michael, and Mueller, Christian

Published
2018
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10. Diagnostic Accuracy of the Aortic Dissection Detection Risk Score Plus D-Dimer for Acute Aortic Syndromes: The ADvISED Prospective Multicenter Study

Author

Nazerian, Peiman, Mueller, Christian, Soeiro, Alexandre de Matos, Leidel, Bernd A., Salvadeo, Sibilla Anna Teresa, Giachino, Francesca, Vanni, Simone, Grimm, Karin, Oliveira, Múcio Tavares, Jr, Pivetta, Emanuele, Lupia, Enrico, Grifoni, Stefano, Morello, Fulvio, Capretti, Elisa, Castelli, Matteo, Gualtieri, Simona, Trausi, Federica, Battista, Stefania, Bima, Paolo, Carbone, Federica, Tizzani, Maria, Veglio, Maria G., Badertscher, Patrick, Boeddinghaus, Jasper, Nestelberger, Thomas, and Twerenbold, Raphael

Published
2018
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11. Direct Comparison of Cardiac Myosin-Binding Protein C With Cardiac Troponins for the Early Diagnosis of Acute Myocardial Infarction

Author

Kaier, Thomas E., Twerenbold, Raphael, Puelacher, Christian, Marjot, Jack, Imambaccus, Nazia, Boeddinghaus, Jasper, Nestelberger, Thomas, Badertscher, Patrick, Sabti, Zaid, Giménez, Maria Rubini, Wildi, Karin, Hillinger, Petra, Grimm, Karin, Loeffel, Sarah, Shrestha, Samyut, Widmer, Dayana Flores, Cupa, Janosch, Kozhuharov, Nikola, Miró, Òscar, Martín-Sánchez, F. Javier, Morawiec, Beata, Rentsch, Katharina, Lohrmann, Jens, Kloos, Wanda, Osswald, Stefan, Reichlin, Tobias, Weber, Ekkehard, Marber, Michael, and Mueller, Christian

Published
2017
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12. Direct Comparison of 4 Very Early Rule-Out Strategies for Acute Myocardial Infarction Using High-Sensitivity Cardiac Troponin I

Author

Boeddinghaus, Jasper, Nestelberger, Thomas, Twerenbold, Raphael, Wildi, Karin, Badertscher, Patrick, Cupa, Janosch, Bürge, Tobias, Mächler, Patrick, Corbière, Sydney, Grimm, Karin, Giménez, Maria Rubini, Puelacher, Christian, Shrestha, Samyut, Flores Widmer, Dayana, Fuhrmann, Jakob, Hillinger, Petra, Sabti, Zaid, Honegger, Ursina, Schaerli, Nicolas, Kozhuharov, Nikola, Rentsch, Katharina, Miró, Òscar, López, Beatriz, Martin-Sanchez, F. Javier, Rodriguez-Adrada, Esther, Morawiec, Beata, Kawecki, Damian, Ganovská, Eva, Parenica, Jiri, Lohrmann, Jens, Kloos, Wanda, Buser, Andreas, Geigy, Nicolas, Keller, Dagmar I., Osswald, Stefan, Reichlin, Tobias, and Mueller, Christian

Published
2017
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13. One-hour rule-in and rule-out of acute myocardial infarction using high-sensitivity cardiac troponin I

Author

Jaeger, Cedric, Wildi, Karin, Twerenbold, Raphael, Reichlin, Tobias, Gimenez, Maria Rubini, Neuhaus, Jean-Daniel, Grimm, Karin, Boeddinghaus, Jasper, Hillinger, Petra, Nestelberger, Thomas, Singeisen, Helene, Gugala, Mathias, Pretre, Gil, Puelacher, Christian, Wagener, Max, Honegger, Ursina, Schumacher, Carmela, Weidmann, Zoraida Moreno, Kreutzinger, Philipp, Krivoshei, Lian, Freese, Michael, Stelzig, Claudia, Dietsche, Sebastian, Ernst, Susanne, Rentsch, Katharina, Osswald, Stefan, and Mueller, Christian

Published
2016
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14. Diagnostic and prognostic value of ST-segment deviation scores in suspected acute myocardial infarction

Author

Grimm, Karin, primary, Twerenbold, Raphael, additional, Abaecherli, Roger, additional, Boeddinghaus, Jasper, additional, Nestelberger, Thomas, additional, Koechlin, Luca, additional, Troester, Valentina, additional, Bourtzou, Anna, additional, Keller, Dagmar I, additional, Geigy, Nicolas, additional, Kozhuharov, Nikola, additional, Wussler, Desiree, additional, Wildi, Karin, additional, Hillinger, Petra, additional, Rubini Giménez, Maria, additional, Strebel, Ivo, additional, Badertscher, Patrick, additional, Puelacher, Christian, additional, du Fay de Lavallaz, Jeanne, additional, Osswald, Luca, additional, Morawiec, Beata, additional, Kawecki, Damian, additional, Miró, Òscar, additional, Kühne, Michael, additional, Reichlin, Tobias, additional, and Mueller, Christian, additional

Published
2020
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15. Une IRM ne peut pas remplacer le jugement clinique

Author

Grimm, Karin, primary, Venturini, Stefan, additional, Treusch, Marius, additional, von Rotz, Matthias, additional, Amstadt, Andrea Katja, additional, Walker, Ulrich A., additional, Sendi, Parham, additional, Bassetti, Stefano, additional, and Weber, Martin, additional

Published
2020
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18. Cause inhabituelle de maux de dos

Author

von Rotz, Matthias, primary, Grimm, Karin, additional, Arranto, Christian, additional, Burkhalter, Felix, additional, Erb, Stefan, additional, Trendelenburg, Marten, additional, and Breidthardt, Tobias, additional

Published
2019
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19. Diagnosis of acute myocardial infarction in the presence of left bundle branch block

Author

Nestelberger, Thomas, Cullen, Louise, Lindahl, Bertil, Reichlin, Tobias, Greenslade, Jaimi H., Giannitsis, Evangelos, Christ, Michael, Morawiec, Beata, Miro, Oscar, Martín-Sánchez, Francisco Javier, Wussler, Desiree Nadine, Koechlin, Luca, Twerenbold, Raphael, Parsonage, William, Boeddinghaus, Jasper, Rubini Gimenez, Maria, Puelacher, Christian, Wildi, Karin, Buerge, Tobias, Badertscher, Patrick, DuFaydeLavallaz, Jeanne, Strebel, Ivo, Croton, Lukas, Bendig, Garnet, Osswald, Stefan, Pickering, John William, Than, Martin, Mueller, Christian, Hillinger, Petra, Grimm, Karin, Honegger, Ursina, Schaerli, Nicolas, Kozhuharov, Nikola, Stelzig, Claudia, Freese, Michael, Sabti, Zaid, Walter, Joan, Sazgary, Lorraine, Kulangara, Caroline, Meissner, Kathrin, Mueller, Deborah, Lopez, Beatriz, Salgado, Emilio, Adrada, Esther Rodríguez, Kawecki, Damian, Parenica, Jiri, Ganovska, Eva, Rentsch, Katharina, Buser, Andreas, Lohrmann, Jens, Bingisser, Roland, Shrestha, Samyut, Stallone, Fabio, Abaecherli, Roger, McCord, James, Nowak, Richard, Body, Richard, DeFilippi, Christopher R., Christenson, Robert H., Panteghini, Mauro, Plebani, Mario, Verschuren, Franck, French, John, Weiser, Silvia, Dinkel, Carina, Keller, Dagmar I., Geigy, Nicolas, Nestelberger, Thomas, Cullen, Louise, Lindahl, Bertil, Reichlin, Tobias, Greenslade, Jaimi H., Giannitsis, Evangelos, Christ, Michael, Morawiec, Beata, Miro, Oscar, Martín-Sánchez, Francisco Javier, Wussler, Desiree Nadine, Koechlin, Luca, Twerenbold, Raphael, Parsonage, William, Boeddinghaus, Jasper, Rubini Gimenez, Maria, Puelacher, Christian, Wildi, Karin, Buerge, Tobias, Badertscher, Patrick, DuFaydeLavallaz, Jeanne, Strebel, Ivo, Croton, Lukas, Bendig, Garnet, Osswald, Stefan, Pickering, John William, Than, Martin, Mueller, Christian, Hillinger, Petra, Grimm, Karin, Honegger, Ursina, Schaerli, Nicolas, Kozhuharov, Nikola, Stelzig, Claudia, Freese, Michael, Sabti, Zaid, Walter, Joan, Sazgary, Lorraine, Kulangara, Caroline, Meissner, Kathrin, Mueller, Deborah, Lopez, Beatriz, Salgado, Emilio, Adrada, Esther Rodríguez, Kawecki, Damian, Parenica, Jiri, Ganovska, Eva, Rentsch, Katharina, Buser, Andreas, Lohrmann, Jens, Bingisser, Roland, Shrestha, Samyut, Stallone, Fabio, Abaecherli, Roger, McCord, James, Nowak, Richard, Body, Richard, DeFilippi, Christopher R., Christenson, Robert H., Panteghini, Mauro, Plebani, Mario, Verschuren, Franck, French, John, Weiser, Silvia, Dinkel, Carina, Keller, Dagmar I., and Geigy, Nicolas

Abstract

Objective Patients with suspected acute myocardial infarction (AMI) in the setting of left bundle branch block (LBBB) present an important diagnostic and therapeutic challenge to the clinician. Methods We prospectively evaluated the incidence of AMI and diagnostic performance of specific ECG and high-sensitivity cardiac troponin (hs-cTn) criteria in patients presenting with chest discomfort to 26 emergency departments in three international, prospective, diagnostic studies. The final diagnosis of AMI was centrally adjudicated by two independent cardiologists according to the universal definition of myocardial infarction. Results Among 8830 patients, LBBB was present in 247 (2.8%). AMI was the final diagnosis in 30% of patients with LBBB, with similar incidence in those with known LBBB versus those with presumably new LBBB (29% vs 35%, p=0.42). ECG criteria had low sensitivity (1%-12%) but high specificity (95%-100%) for AMI. The diagnostic accuracy as quantified by the receiver operating characteristics (ROC) curve of hs-cTnT and hs-cTnI concentrations at presentation (area under the ROC curve (AUC) 0.91, 95% CI 0.85 to 0.96 and AUC 0.89, 95% CI 0.83 to 0.95), as well as that of their 0/1-hour and 0/2-hour changes, was very high. A diagnostic algorithm combining ECG criteria with hs-cTnT/I concentrations and their absolute changes at 1 hour or 2 hours derived in cohort 1 (45 of 45(100%) patients with AMI correctly identified) showed high efficacy and accuracy when externally validated in cohorts 2 and 3 (28 of 29 patients, 97%). Conclusion Most patients presenting with suspected AMI and LBBB will be found to have diagnoses other than AMI. Combining ECG criteria with hs-cTnT/I testing at 0/1 hour or 0/2 hours allows early and accurate diagnosis of AMI in LBBB. Trial registration number APACE: NCT00470587; ADAPT: ACTRN12611001069943; TRAPID-AMI: RD001107;Results.

Published
2019

20. Clinical Use of a New High-Sensitivity Cardiac Troponin I Assay in Patients with Suspected Myocardial Infarction

Author

Boeddinghaus, Jasper, primary, Twerenbold, Raphael, additional, Nestelberger, Thomas, additional, Koechlin, Luca, additional, Wussler, Desiree, additional, Meier, Mario, additional, Troester, Valentina, additional, Zimmermann, Tobias, additional, Badertscher, Patrick, additional, Wildi, Karin, additional, Rubini Giménez, Maria, additional, Lopez-Ayala, Pedro, additional, Potlukova, Eliska, additional, Miró, Òscar, additional, Martin-Sanchez, F Javier, additional, Kawecki, Damian, additional, Geigy, Nicolas, additional, Keller, Dagmar I, additional, Reichlin, Tobias, additional, Mueller, Christian, additional, du Fay de Lavallaz, Jeanne, additional, Walter, Joan Elias, additional, Freese, Michael, additional, Puelacher, Christian, additional, Hafner, Benjamin, additional, Strebel, Ivo, additional, Kozhuharov, Nikola, additional, Rentsch, Katharina, additional, Gualandro, Danielle M, additional, Schaerli, Nicolas, additional, Stelzig, Claudia, additional, Meissner, Kathrin, additional, Kulangara, Caroline, additional, Hillinger, Petra, additional, Grimm, Karin, additional, Michou, Eleni, additional, Flores, Dayana, additional, Czmok, Rafael, additional, Osswald, Stefan, additional, López, Beatriz, additional, Fuenzalida, Carolina, additional, Rodriguez Adrada, Esther, additional, Ganovská, Eva, additional, Lohrmann, Jens, additional, Kloos, Wanda, additional, Christ, Michael, additional, Steude, Jana, additional, Fahrni, Gregor, additional, Buser, Andreas, additional, von Eckardstein, Arnold, additional, Morawiec, Beata, additional, Nowalany-Kozielska, Ewa, additional, and Muzyk, Piotr, additional

Published
2019
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21. Predicting Major Adverse Events in Patients With Acute Myocardial Infarction

Author

Nestelberger, Thomas, primary, Boeddinghaus, Jasper, additional, Wussler, Desiree, additional, Twerenbold, Raphael, additional, Badertscher, Patrick, additional, Wildi, Karin, additional, Miró, Òscar, additional, López, Beatriz, additional, Martin-Sanchez, F. Javier, additional, Muzyk, Piotr, additional, Koechlin, Luca, additional, Baumgartner, Benjamin, additional, Meier, Mario, additional, Troester, Valentina, additional, Rubini Giménez, Maria, additional, Puelacher, Christian, additional, du Fay de Lavallaz, Jeanne, additional, Walter, Joan, additional, Kozhuharov, Nikola, additional, Zimmermann, Tobias, additional, Gualandro, Danielle M., additional, Michou, Eleni, additional, Potlukova, Eliska, additional, Geigy, Nicolas, additional, Keller, Dagmar I., additional, Reichlin, Tobias, additional, Mueller, Christian, additional, Hafner, Benjamin, additional, Flores, Dayana, additional, Meissner, Kathrin, additional, Kulangara, Caroline, additional, Freese, Michael, additional, Osswald, Stefan, additional, Stelzig, Claudia, additional, Bingisser, Roland, additional, Fuenzalida Inostroza, Carolina Isabel, additional, Rodríguez Adrada, Esther, additional, Nowalany-Kozielska, Ewa, additional, Kawecki, Damian, additional, Parenica, Jiri, additional, Ganovská, Eva, additional, Lohrmann, Jens, additional, Amrein, Melissa, additional, Steude, Jana, additional, Buser, Andreas, additional, Grimm, Karin, additional, Hartmann, Beate, additional, Morawiec, Beata, additional, Rentsch, Katharina, additional, von Eckardstein, Arnold, additional, Biskup, Ewalina, additional, Campodarve, Isabel, additional, and Gea, Joachim, additional

Published
2019
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22. Comparison of fourteen rule-out strategies for acute myocardial infarction

Author

Wildi, Karin, primary, Boeddinghaus, Jasper, additional, Nestelberger, Thomas, additional, Twerenbold, Raphael, additional, Badertscher, Patrick, additional, Wussler, Desiree, additional, Giménez, Maria Rubini, additional, Puelacher, Christian, additional, du Fay de Lavallaz, Jeanne, additional, Dietsche, Sebastian, additional, Walter, Joan, additional, Kozhuharov, Nikola, additional, Morawiec, Beata, additional, Miró, Òscar, additional, Javier Martin-Sanchez, F., additional, Subramaniam, Sinthuri, additional, Geigy, Nicolas, additional, Keller, Dagmar I., additional, Reichlin, Tobias, additional, Mueller, Christian, additional, Mueller, Deborah, additional, Sazgary, Lorraine, additional, Marbot, Stella, additional, Sabti, Zaid, additional, Flores, Dayana, additional, Meissner, Kathrin, additional, Kulangara, Caroline, additional, Freese, Michael, additional, Osswald, Stefan, additional, Stelzig, Claudia, additional, Bingisser, Roland, additional, López, Beatriz, additional, Agüero, María Martínez, additional, Nowalany-Kozielska, Ewa, additional, Kawecki, Damian, additional, Parenica, Jiri, additional, Ganovská, Eva, additional, Lohrmann, Jens, additional, Buser, Andreas, additional, Grimm, Karin, additional, Hartmann, Beate, additional, Muzyk, Piotr, additional, Rentsch, Katharina, additional, and von Eckardstein, Arnold, additional

Published
2019
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23. Diagnostic value of the cardiac electrical biomarker, a novel ECG marker indicating myocardial injury, in patients with symptoms suggestive of non-ST-elevation myocardial infarction

Author

Strebel, Ivo, primary, Twerenbold, Raphael, additional, Boeddinghaus, Jasper, additional, Abächerli, Roger, additional, Rubini Giménez, Maria, additional, Wildi, Karin, additional, Grimm, Karin, additional, Puelacher, Christian, additional, Badertscher, Patrick, additional, Sabti, Zaid, additional, Breitenbücher, Dominik, additional, Jann, Janina, additional, Selman, Farah, additional, du Fay de Lavallaz, Jeanne, additional, Schaerli, Nicolas, additional, Nestelberger, Thomas, additional, Stelzig, Claudia, additional, Freese, Michael, additional, Schumacher, Lukas, additional, Osswald, Stefan, additional, Mueller, Christian, additional, and Reichlin, Tobias, additional

Published
2018
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24. Diagnostic and prognostic value of the QRS-T-angle, an ECG marker quantifying heterogeneity of depolarization and repolarization, in patients with suspected non-ST-elevation myocardial infarction

Author

Strebel, Ivo, primary, Twerenbold, Raphael, additional, Boeddinghaus, Jasper, additional, Abächerli, Roger, additional, Cupa, Janosch, additional, Giménez, Maria Rubini, additional, Wildi, Karin, additional, Grimm, Karin, additional, Puelacher, Christian, additional, Osswald, Stefan, additional, Mueller, Christian, additional, and Reichlin, Tobias, additional

Published
2018
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25. Effects of hemolysis on the diagnostic accuracy of cardiac troponin I for the diagnosis of myocardial infarction

Author

Puelacher, Christian, Twerenbold, Raphael, Mosimann, Tamina, Boeddinghaus, Jasper, Rubini Gimenez, Maria, Wildi, Karin, Jaeger, Cédric, Reichlin, Tobias, Schneider, Jeannine, Honegger, Ursina, Max, Wagener, Schumacher, Carmela, Nestelberger, Thomas, Hillinger, Petra, Grimm, Karin, Kreutzinger, Philipp, Moreno Weidmann, Zoraida, Rentsch, Katharina, Arnold, Christiane, Osswald, Stefan, and Mueller, Christian

Published
2015
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26. Diagnostic and prognostic value of the QRS-T-angle, an ECG marker quantifying heterogeneity of depolarization and repolarization, in patients with suspected non-ST-elevation myocardial infarction

Author

Abächerli, Roger, primary, Boeddinghaus, Jasper, additional, Cupa, Janosch, additional, Giménez, Maria Rubini, additional, Grimm, Karin, additional, Mueller, Christian, additional, Osswald, Stefan, additional, Puelacher, Christian, additional, Reichlin, Tobias, additional, Strebel, Ivo, additional, Twerenbold, Raphael, additional, and Wildi, Karin, additional

Published
2017
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27. Direct Comparison of 2 Rule-Out Strategies for Acute Myocardial Infarction: 2-h Accelerated Diagnostic Protocol vs 2-h Algorithm

Author

Wildi, Karin, primary, Cullen, Louise, primary, Twerenbold, Raphael, primary, Greenslade, Jaimi H, primary, Parsonage, William, primary, Boeddinghaus, Jasper, primary, Nestelberger, Thomas, primary, Sabti, Zaid, primary, Rubini-Giménez, Maria, primary, Puelacher, Christian, primary, Cupa, Janosch, primary, Schumacher, Lukas, primary, Badertscher, Patrick, primary, Grimm, Karin, primary, Kozhuharov, Nikola, primary, Stelzig, Claudia, primary, Freese, Michael, primary, Rentsch, Katharina, primary, Lohrmann, Jens, primary, Kloos, Wanda, primary, Buser, Andreas, primary, Reichlin, Tobias, primary, Pickering, John W, primary, Than, Martin, primary, and Mueller, Christian, primary

Published
2017
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28. Diurnal Rhythm of Cardiac Troponin: Consequences for the Diagnosis of Acute Myocardial Infarction

Author

Klinkenberg, Lieke J J, primary, Wildi, Karin, primary, van der Linden, Noreen, primary, Kouw, Imre W K, primary, Niens, Marijke, primary, Twerenbold, Raphael, primary, Rubini Gimenez, Maria, primary, Puelacher, Christian, primary, Daniel Neuhaus, Jean, primary, Hillinger, Petra, primary, Nestelberger, Thomas, primary, Boeddinghaus, Jasper, primary, Grimm, Karin, primary, Sabti, Zaid, primary, Bons, Judith A P, primary, van Suijlen, Jeroen D E, primary, Tan, Frans E S, primary, ten Kate, Joop, primary, Bekers, Otto, primary, van Loon, Luc J C, primary, van Dieijen-Visser, Marja P, primary, Mueller, Christian, primary, and Meex, Steven J R, primary

Published
2016
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29. Two-hour algorithm for triage toward rule-out and rule-in of acute myocardial infarction by use of high-sensitivity cardiac troponin I

Author

Boeddinghaus, Jasper, Reichlin, Tobias, Cullen, Louise, Greenslade, Jaimi, Parsonage, Will, Hammett, Christopher, Pickering, John, Hawkins, Tracey, Aldous, Sally, Twerenbold, Raphael, Wildi, Karin, Nestelberger, Thomas, Grimm, Karin, Gimenez, Maria, Puelacher, Christian, Kern, Vera, Rentsch, Katharina, Than, Martin, Mueller, Christian, Boeddinghaus, Jasper, Reichlin, Tobias, Cullen, Louise, Greenslade, Jaimi, Parsonage, Will, Hammett, Christopher, Pickering, John, Hawkins, Tracey, Aldous, Sally, Twerenbold, Raphael, Wildi, Karin, Nestelberger, Thomas, Grimm, Karin, Gimenez, Maria, Puelacher, Christian, Kern, Vera, Rentsch, Katharina, Than, Martin, and Mueller, Christian

Abstract

Free to read Abstract BACKGROUND: The early triage of patients toward rule-out and rule-in of acute myocardial infarction (AMI) is challenging. Therefore, we aimed to develop a 2-h algorithm that uses high-sensitivity cardiac troponin I (hs-cTnI). METHODS: We prospectively enrolled 1435 (derivation cohort) and 1194 (external validation cohort) patients presenting with suspected AMI to the emergency department. The final diagnosis was adjudicated by 2 independent cardiologists. hs-cTnI was measured at presentation and after 2 h in a blinded fashion. We derived and validated a diagnostic algorithm incorporating hs-cTnI values at presentation and absolute changes within the first 2 h. RESULTS: AMI was the final diagnosis in 17% of patients in the derivation and 13% in the validation cohort. The 2-h algorithm developed in the derivation cohort classified 56% of patients as rule-out, 17% as rule-in, and 27% as observation. Resulting diagnostic sensitivity and negative predictive value (NPV) were 99.2% and 99.8% for rule-out; specificity and positive predictive value (PPV) were 95.2% and 75.8% for rule-in. Applying the 2-h algorithm in the external validation cohort, 60% of patients were classified as rule-out, 13% as rule-in, and 27% as observation. Diagnostic sensitivity and NPV were 98.7% and 99.7% for rule-out; specificity and PPV were 97.4% and 82.2% for rule-in. Thirty-day survival was 100% for rule-out patients in both cohorts. CONCLUSIONS: A simple algorithm incorporating hs-cTnI baseline values and absolute 2-h changes allowed a triage toward safe rule-out or accurate rule-in of AMI in the majority of patients.

Published
2016

30. Clinical Effect of Sex-Specific Cutoff Values of High-Sensitivity Cardiac Troponin T in Suspected Myocardial Infarction

Author

Rubini Giménez, Maria, primary, Twerenbold, Raphael, additional, Boeddinghaus, Jasper, additional, Nestelberger, Thomas, additional, Puelacher, Christian, additional, Hillinger, Petra, additional, Wildi, Karin, additional, Jaeger, Cedric, additional, Grimm, Karin, additional, Heitzelmann, Karl-Frieder, additional, Sabti, Zaid, additional, Badertscher, Patrick, additional, Cupa, Janosch, additional, Honegger, Ursina, additional, Schaerli, Nicolas, additional, Kozhuharov, Nikola, additional, du Fay de Lavallaz, Jeanne, additional, Lopez, Beatriz, additional, Salgado, Emilio, additional, Miró, Òscar, additional, Martín-Sánchez, F.Javier, additional, Adrada, Esther Rodríguez, additional, Morawiec, Beata, additional, Parenica, Jiri, additional, Ganovska, Eva, additional, Neugebauer, Claire, additional, Rentsch, Katharina, additional, Lohrmann, Jens, additional, Osswald, Stefan, additional, Reichlin, Tobias, additional, and Mueller, Christian, additional

Published
2016
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31. Gender-specific uncertainties in the diagnosis of acute coronary syndrome

Author

Hillinger, Petra, primary, Twerenbold, Raphael, additional, Wildi, Karin, additional, Rubini Gimenez, Maria, additional, Jaeger, Cedric, additional, Boeddinghaus, Jasper, additional, Nestelberger, Thomas, additional, Grimm, Karin, additional, Reichlin, Tobias, additional, Stallone, Fabio, additional, Puelacher, Christian, additional, Sabti, Zaid, additional, Kozhuharov, Nikola, additional, Honegger, Ursina, additional, Ballarino, Paola, additional, Miro, Oscar, additional, Denhaerynck, Kris, additional, Ekrem, Temizel, additional, Kohler, Claudia, additional, Bingisser, Roland, additional, Osswald, Stefan, additional, and Mueller, Christian, additional

Published
2016
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32. Impact of high-sensitivity cardiac troponin on use of coronary angiography, cardiac stress testing, and time to discharge in suspected acute myocardial infarction

Author

Twerenbold, Raphael, primary, Jaeger, Cedric, additional, Rubini Gimenez, Maria, additional, Wildi, Karin, additional, Reichlin, Tobias, additional, Nestelberger, Thomas, additional, Boeddinghaus, Jasper, additional, Grimm, Karin, additional, Puelacher, Christian, additional, Moehring, Berit, additional, Pretre, Gil, additional, Schaerli, Nicolas, additional, Campodarve, Isabel, additional, Rentsch, Katharina, additional, Steuer, Stephan, additional, Osswald, Stefan, additional, and Mueller, Christian, additional

Published
2016
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33. Two-Hour Algorithm for Triage toward Rule-Out and Rule-In of Acute Myocardial Infarction by Use of High-Sensitivity Cardiac Troponin I

Author

Boeddinghaus, Jasper, primary, Reichlin, Tobias, primary, Cullen, Louise, primary, Greenslade, Jaimi H, primary, Parsonage, William A, primary, Hammett, Christopher, primary, Pickering, John W, primary, Hawkins, Tracey, primary, Aldous, Sally, primary, Twerenbold, Raphael, primary, Wildi, Karin, primary, Nestelberger, Thomas, primary, Grimm, Karin, primary, Rubini Gimenez, Maria, primary, Puelacher, Christian, primary, Kern, Vera, primary, Rentsch, Katharina, primary, Than, Martin, primary, and Mueller, Christian, primary

Published
2016
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34. Clinical Effect of Sex-Specific Cutoff Values of High-Sensitivity Cardiac Troponin T in Suspected Myocardial Infarction.

Author

Giménez, Maria Rubini, Twerenbold, Raphael, Boeddinghaus, Jasper, Nestelberger, Thomas, Puelacher, Christian, Hillinger, Petra, Wildi, Karin, Jaeger, Cedric, Grimm, Karin, Heitzelmann, Karl-Frieder, Sabti, Zaid, Badertscher, Patrick, Cupa, Janosch, Honegger, Ursina, Schaerli, Nicolas, Kozhuharov, Nikola, du Fay de Lavallaz, Jeanne, Lopez, Beatriz, Salgado, Emilio, and Miró, Òscar

Published
2016
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35. Clinical impact of the 2010–2012 low-end shift of high-sensitivity cardiac troponin T

Author

Wildi, Karin, Twerenbold, Raphael, Jaeger, Cedric, Rubini Giménez, Maria, Reichlin, Tobias, Stoll, Melanie, Hillinger, Petra, Puelacher, Christian, Boeddinghaus, Jasper, Nestelberger, Thomas, Grimm, Karin, Grob, Maja, Rentsch, Katharina, Arnold, Christiane, and Mueller, Christian

Abstract

Background: The clinical implications of the 2010–2012 low-end shift of high-sensitivity cardiac troponin T (hs-cTnT) regarding possible misdiagnosis of acute myocardial infarction are largely unknown.Methods: We aimed to quantify the impact of the 2010–2012 low-end shift and adjustment issue in 857 patients presenting to the emergency department with suspected acute myocardial infarction by comparing measurements performed with affected 2010–2012 lots with recalculated 2010–2012 values using a linear regression formula (provided by the manufacturer) and the corrected assay (re-measured in 2013). The final diagnosis was adjudicated by two independent cardiologists using all information including coronary angiography, echocardiography and serial hs-cTnT levels (with the corrected 2013 assay).Results: Acute myocardial infarction was the adjudicated diagnosis in 195 patients (22.7%). Median hs-TnT values were 8.5 ng/l for affected lots, 11.1 ng/l with recalculated and 10 ng/l with the corrected assay (P<0.001 for all comparisons). Spearman correlation coefficient was 0.937 (<0.001) for correct and affected respective correct and recalculated values. The Cusum test indicated significant deviation from linearity (P<0.01) for both correlations. Deviations nearly exclusively affected hs-cTnT levels below the 99th percentile (14 ng/L). Among the 195 patients with an adjudicated diagnosis of acute myocardial infarction, no patient was misclassified using affected lots if using conventional serial sampling. In contrast, misdiagnosis of acute myocardial infarction was significantly increased by affected lots if applying the novel ESC 0 h/1 h algorithm for the early rule-out of acute myocardial infarction (negative predictive value with affected lots 97.7% versus 99.7% with corrected lots).Conclusion: The 2010–2012 hs-cTnT low-end shift affected nearly exclusively levels below the 99th percentile cut-off. While it did not affect the diagnosis of acute myocardial infarction when using conventional serial sampling as done in 2010–2012, it would impact on new early rule-out strategies using very low levels of hs-cTnT such as the ESC 0 h/1 h algorithm.Clinical Trials registration: NCT0047058, NCT00470587

Published
2016
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36. Clinical impact of the 2010-2012 low-end shift of high-sensitivity cardiac troponin T.

Author

Wildi K, Twerenbold R, Jaeger C, Rubini Giménez M, Reichlin T, Stoll M, Hillinger P, Puelacher C, Boeddinghaus J, Nestelberger T, Grimm K, Grob M, Rentsch K, Arnold C, and Mueller C

Subjects
Aged, Algorithms, Biomarkers blood, Diagnostic Errors, Electrocardiography, Female, Humans, Male, Middle Aged, Observer Variation, Prospective Studies, Sensitivity and Specificity, Myocardial Infarction diagnosis, Troponin T blood
Abstract

Background: The clinical implications of the 2010-2012 low-end shift of high-sensitivity cardiac troponin T (hs-cTnT) regarding possible misdiagnosis of acute myocardial infarction are largely unknown., Methods: We aimed to quantify the impact of the 2010-2012 low-end shift and adjustment issue in 857 patients presenting to the emergency department with suspected acute myocardial infarction by comparing measurements performed with affected 2010-2012 lots with recalculated 2010-2012 values using a linear regression formula (provided by the manufacturer) and the corrected assay (re-measured in 2013). The final diagnosis was adjudicated by two independent cardiologists using all information including coronary angiography, echocardiography and serial hs-cTnT levels (with the corrected 2013 assay)., Results: Acute myocardial infarction was the adjudicated diagnosis in 195 patients (22.7%). Median hs-TnT values were 8.5 ng/l for affected lots, 11.1 ng/l with recalculated and 10 ng/l with the corrected assay (P<0.001 for all comparisons). Spearman correlation coefficient was 0.937 (<0.001) for correct and affected respective correct and recalculated values. The Cusum test indicated significant deviation from linearity (P<0.01) for both correlations. Deviations nearly exclusively affected hs-cTnT levels below the 99th percentile (14 ng/L). Among the 195 patients with an adjudicated diagnosis of acute myocardial infarction, no patient was misclassified using affected lots if using conventional serial sampling. In contrast, misdiagnosis of acute myocardial infarction was significantly increased by affected lots if applying the novel ESC 0 h/1 h algorithm for the early rule-out of acute myocardial infarction (negative predictive value with affected lots 97.7% versus 99.7% with corrected lots)., Conclusion: The 2010-2012 hs-cTnT low-end shift affected nearly exclusively levels below the 99th percentile cut-off. While it did not affect the diagnosis of acute myocardial infarction when using conventional serial sampling as done in 2010-2012, it would impact on new early rule-out strategies using very low levels of hs-cTnT such as the ESC 0 h/1 h algorithm., Clinical Trials Registration: NCT0047058, NCT00470587., (© The European Society of Cardiology 2016.)

Published
2016
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