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3. Hyperacute T Wave in the Early Diagnosis of Acute Myocardial Infarction

Author

Meier, Mario, Troester, Valentina, Diebold, Matthias, Huber, Jeffrey, Baumgartner, Benjamin, Potlukova, Eliska, Hafner, Benjamin, Schoepfer, Hadrien, Buechi, Michael, Coscia, Tania, Geigy, Nicolas, Anwar, Mahnoor, Puelacher, Christian, du Fay de Lavallaz, Jeanne, Glarner, Noemi, Freese, Michael, Belkin, Maria, Lopez, Beatriz, Calderón, Sofia, Adrada, Esther Rodriguez, Morawiec, Beata, Munzyk, Piotr, von Eckardstein, Arnold, Campodarve, Isabel, Mitrovic, Sandra, Rentsch, Katharina, Buser, Andreas, Osswald, Stefan, Koechlin, Luca, Strebel, Ivo, Zimmermann, Tobias, Nestelberger, Thomas, Walter, Joan, Lopez-Ayala, Pedro, Boeddinghaus, Jasper, Shrestha, Samyut, Arslani, Ketina, Stefanelli, Sabrina, Reuthebuch, Benedikt, Wussler, Desiree, Ratmann, Paul David, Christ, Michael, Badertscher, Patrick, Wildi, Karin, Giménez, Maria Rubini, Gualandro, Danielle M., Miró, Òscar, Fuenzalida, Carolina, Martin-Sanchez, F. Javier, Kawecki, Damian, Bürgler, Franz, Keller, Dagmar I., Abächerli, Roger, Reuthebuch, Oliver, Eckstein, Friedrich S., Twerenbold, Raphael, Reichlin, Tobias, and Mueller, Christian

Published
2023
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4. Major low‐energy trauma results in non‐specific immunoglobulin generation without evidence for specific autoantibody production: A prospective cohort study

Author

Eckardt, Henrik, primary, Bless, Nicolas, additional, Heijnen, Ingmar, additional, Morgenstern, Mario, additional, Nehring, Josephine, additional, Kieninger‐Gräfitsch, Andrea, additional, Bouchenaki, Martine, additional, Durandin, Vanessa, additional, Purschke, Silke, additional, Schmidt, Ina, additional, Kouba, Loraine Pascale, additional, Trendelenburg, Marten, additional, and Potlukova, Eliska, additional

Published
2024
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5. 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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6. External validation of the myocardial-ischaemic-injury-index machine learning algorithm for the early diagnosis of myocardial infarction: a multicentre cohort study

Author

Lopez-Ayala, Pedro, Boeddinghaus, Jasper, Nestelberger, Thomas, Koechlin, Luca, Zimmermann, Tobias, Bima, Paolo, Glaeser, Jonas, Spagnuolo, Carlos C, Champetier, Arnaud, Miro, Oscar, Martin-Sanchez, Francisco Javier, Keller, Dagmar I, Christ, Michael, Wildi, Karin, Breidthardt, Tobias, Strebel, Ivo, Mueller, Christian, Reichlin, Tobias, Kaeslin, Marina, Potlukova, Eliska, Kawecki, Damian, Geigy, Nicolas, Rentsch, Katharina, Shrestha, Samyut, Guzman-Tacla, Caroline A., Herraiz-Recuenco, Lourdes, Morawiec, Beata, Munzk, Piotr, Freese, Michael, Martinez-Nadal, Gemma, Fuenzalida, Carolina, Calderon, Sofia, Rodriguez Adrada, Esther, Ganovská, Eva, Parenica, Jiri, von Eckardstein, Arnold, Campodarve, Isabel, and Gea, Joachim

Abstract

The myocardial-ischaemic-injury-index (MI3) is a novel machine learning algorithm for the early diagnosis of type 1 non-ST-segment elevation myocardial infarction (NSTEMI). The performance of MI3, both when using early serial blood draws (eg, at 1 h or 2 h) and in direct comparison with guideline-recommended algorithms, remains unknown. Our aim was to externally validate MI3and compare its performance with that of the European Society of Cardiology (ESC) 0/1h-algorithm.

Published
2024
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7. Hyperacute T Wave in the Early Diagnosis of Acute Myocardial Infarction

Author

Koechlin, Luca, primary, Strebel, Ivo, additional, Zimmermann, Tobias, additional, Nestelberger, Thomas, additional, Walter, Joan, additional, Lopez-Ayala, Pedro, additional, Boeddinghaus, Jasper, additional, Shrestha, Samyut, additional, Arslani, Ketina, additional, Stefanelli, Sabrina, additional, Reuthebuch, Benedikt, additional, Wussler, Desiree, additional, Ratmann, Paul David, additional, Christ, Michael, additional, Badertscher, Patrick, additional, Wildi, Karin, additional, Giménez, Maria Rubini, additional, Gualandro, Danielle M., additional, Miró, Òscar, additional, Fuenzalida, Carolina, additional, Martin-Sanchez, F. Javier, additional, Kawecki, Damian, additional, Bürgler, Franz, additional, Keller, Dagmar I., additional, Abächerli, Roger, additional, Reuthebuch, Oliver, additional, Eckstein, Friedrich S., additional, Twerenbold, Raphael, additional, Reichlin, Tobias, additional, Mueller, Christian, additional, Meier, Mario, additional, Troester, Valentina, additional, Diebold, Matthias, additional, Huber, Jeffrey, additional, Baumgartner, Benjamin, additional, Potlukova, Eliska, additional, Hafner, Benjamin, additional, Schoepfer, Hadrien, additional, Buechi, Michael, additional, Coscia, Tania, additional, Geigy, Nicolas, additional, Anwar, Mahnoor, additional, Puelacher, Christian, additional, du Fay de Lavallaz, Jeanne, additional, Glarner, Noemi, additional, Freese, Michael, additional, Belkin, Maria, additional, Lopez, Beatriz, additional, Calderón, Sofia, additional, Adrada, Esther Rodriguez, additional, Morawiec, Beata, additional, Munzyk, Piotr, additional, von Eckardstein, Arnold, additional, Campodarve, Isabel, additional, Mitrovic, Sandra, additional, Rentsch, Katharina, additional, Buser, Andreas, additional, and Osswald, Stefan, additional

Published
2023
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11. Actinomycose hépatique primaire

Author

Nieves-Ortega, Ricardo, primary, Potlukova, Eliska, additional, Ercan, Caner, additional, Terracciano, Luigi, additional, Boll, Daniel, additional, Takes, Martin, additional, Kollmar, Otto, additional, and Bassetti, Stefano, additional

Published
2022
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12. Primäre hepatische Aktinomykose

Author

Nieves-Ortega, Ricardo, primary, Potlukova, Eliska, additional, Ercan, Caner, additional, Terracciano, Luigi, additional, Boll, Daniel, additional, Takes, Martin, additional, Kollmar, Otto, additional, and Bassetti, Stefano, additional

Published
2022
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14. Direct Comparison of the 0/1h and 0/3h Algorithms for Early Rule-Out of Acute Myocardial Infarction

Author

Badertscher, Patrick, Boeddinghaus, Jasper, Twerenbold, Raphael, Nestelberger, Thomas, Wildi, Karin, Wussler, Desiree, Schwarz, Jonas, Puelacher, Christian, Rubini Giménez, Maria, Kozhuharov, Nikola, du Fay de Lavallaz, Jeanne, Cerminara, Sara Elisa, Potlukova, Eliska, Rentsch, Katharina, Miró, Òscar, López, Beatriz, Martin-Sanchez, F. Javier, Morawiec, Beata, Muzyk, Piotr, Keller, Dagmar I., Reichlin, Tobias, Mueller, Christian, Sabti, Zaid, Strebel, Ivo, Shrestha, Samyut, Flores, Dayana, Freese, Michael, Stelzig, Claudia, Kulangara, Caroline, Meissner, Kathrin, Schaerli, Nicolas, Mueller, Deborah, Yufera Sanchez, Ana, Sazgary, Lorraine, Marbot, Stella, Fuenzalida, Carolina, Calderón, Sofia, Rodriguez Adrada, Esther, Kawecki, Damian, Nowalany-Kozielska, Ewa, Parenica, Jiri, Ganovská, Eva, von Eckardstein, Arnold, Lohrmann, Jens, Kloos, Wanda, Osswald, Stefan, Buser, Andreas, Bingisser, Roland, and Geigy, Nicolas

Published
2018
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15. Performance of the ESC 0/2h-algorithm using high-sensitivity cardiac troponin I in the early diagnosis of myocardial infarction

Author

Zimmermann, Tobias, Reichlin, Tobias, Christ, Michael, Puelacher, Christian, de Lavallaz, Jeanne du Fay, Potlukova, Eliska, Diebold, Matthias, Kawecki, Damian, Geigy, Nicolas, Rentsch, Katharina, Mitrovic, Sandra, Fuenzalida, Carolina, Glarner, Noemi, Morawiec, Beata, Munzk, Piotr, Breidthardt, Tobias, Freese, Michael, López, Beatriz, Calderón, Sofia, Adrada, Esther Rodriguez, Ganovská, Eva, Parenica, Jiri, von Eckardstein, Arnold, Campodarve, Isabel, Gea, Joaquim, Koechlin, Luca, Boeddinghaus, Jasper, Nestelberger, Thomas, Lopez-Ayala, Pedro, Wussler, Desiree, Shrestha, Samyut, Resa, Tobias, Wildi, Karin, Bakula, Adam, Frey, Simon, Miró, Òscar, Martin-Sanchez, F Javier, Strebel, Ivo, Gualandro, Danielle M, Eckstein, Friedrich S, Reuthebuch, Oliver, Keller, Dagmar I, Twerenbold, Raphael, Giménez, Maria Rubini, and Mueller, Christian

Published
2021
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16. Performance of the ESC 0/2h-algorithm using high-sensitivity cardiac troponin I in the early diagnosis of myocardial infarction

Author

Koechlin, Luca, primary, Boeddinghaus, Jasper, additional, Nestelberger, Thomas, additional, Lopez-Ayala, Pedro, additional, Wussler, Desiree, additional, Shrestha, Samyut, additional, Resa, Tobias, additional, Wildi, Karin, additional, Bakula, Adam, additional, Frey, Simon, additional, Miró, Òscar, additional, Martin-Sanchez, F Javier, additional, Strebel, Ivo, additional, Gualandro, Danielle M, additional, Eckstein, Friedrich S, additional, Reuthebuch, Oliver, additional, Keller, Dagmar I, additional, Twerenbold, Raphael, additional, Giménez, Maria Rubini, additional, Mueller, Christian, additional, Zimmermann, Tobias, additional, Reichlin, Tobias, additional, Christ, Michael, additional, Puelacher, Christian, additional, de Lavallaz, Jeanne du Fay, additional, Potlukova, Eliska, additional, Diebold, Matthias, additional, Kawecki, Damian, additional, Geigy, Nicolas, additional, Rentsch, Katharina, additional, Mitrovic, Sandra, additional, Fuenzalida, Carolina, additional, Glarner, Noemi, additional, Morawiec, Beata, additional, Munzk, Piotr, additional, Breidthardt, Tobias, additional, Freese, Michael, additional, López, Beatriz, additional, Calderón, Sofia, additional, Adrada, Esther Rodriguez, additional, Ganovská, Eva, additional, Parenica, Jiri, additional, von Eckardstein, Arnold, additional, Campodarve, Isabel, additional, and Gea, Joaquim, additional

Published
2021
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17. Utility of Echocardiography in Patients With Suspected Acute Myocardial Infarction and Left Bundle‐Branch Block

Author

Nestelberger, Thomas, primary, Boeddinghaus, Jasper, additional, Lopez Ayala, Pedro, additional, Gehrke, Juliane, additional, Twerenbold, Raphael, additional, Cullen, Louise, additional, Mueller, Christian, additional, Strebel, Ivo, additional, Prepoudis, Alexandra, additional, Gualandro, Danielle M., additional, Puelacher, Christian, additional, du Fay Lavallaz, Jeanne, additional, Frey, Simon Martin, additional, Ratmann, Paul David, additional, Arslani, Ketina, additional, Walter, Joan Elias, additional, Freese, Michael, additional, Shrestha, Samyut, additional, Belkin, Maria, additional, Koechlin, Luca, additional, Hillinger, Petra, additional, Potlukova, Eliska, additional, Rentsch, Katharina, additional, Mitrovic, Sandra, additional, Kawecki, Damian, additional, Morawiec, Beata, additional, Munzk, Piotr, additional, Geigy, Nicolas, additional, Reichlin, Tobias, additional, Martinez‐Nadal, Gemma, additional, Fuenzalida Inostroza, Carolina Isabel, additional, Miró, Òscar, additional, Mandrión, José Bustamante, additional, Martín‐Sánchez, Javier, additional, von Eckardstein, Arnold, additional, Buser, Andreas, additional, Greenslade, Jaimi, additional, Christ, Michael, additional, Giannitsis, Evangelos, additional, and Lindahl, Bertil, additional

Published
2021
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19. Novel Criteria for the Observe-Zone of the ESC 0/1h-hs-cTnT Algorithm

Author

Lopez-Ayala, Pedro, primary, Nestelberger, Thomas, additional, Boeddinghaus, Jasper, additional, Koechlin, Luca, additional, Ratmann, Paul David, additional, Strebel, Ivo, additional, Gehrke, Juliane, additional, Meier, Severin, additional, Walter, Joan, additional, Rubini Gimenez, Maria, additional, Mutschler, Eugenio, additional, Miró, Òscar, additional, López-Barbeito, Beatriz, additional, Martín-Sánchez, Francisco Javier, additional, Rodríguez-Adrada, Esther, additional, Keller, Dagmar I., additional, Newby, L. Kristin, additional, Twerenbold, Raphael, additional, Giannitsis, Evangelos, additional, Lindahl, Bertil, additional, Mueller, Christian, additional, Zimmermann, Tobias, additional, Schoepfer, Hadrien, additional, Coscia, Tania, additional, Troester, Valentina, additional, Reichlin, Tobias, additional, Kaeslin, Marina, additional, Christ, Michael, additional, Meier, Mario, additional, Badertscher, Patrick, additional, Puelacher, Christian, additional, du Fay de Lavallaz, Jeanne, additional, Potlukova, Eliska, additional, Kawecki, Damian, additional, Geigy, Nicolas, additional, Rentsch, Katharina, additional, Shrestha, Samyut, additional, Morawiec, Beata, additional, Munzk, Piotr, additional, Breidthardt, Tobias, additional, Freese, Michael, additional, Martinez-Nadal, Gemma, additional, Fuenzalida, Carolina, additional, Calderón, Sofia, additional, Rodriguez Adrada, Esther, additional, Ganovská, Eva, additional, Parenica, Jiri, additional, von Eckardstein, Arnold, additional, Campodarve, Isabel, additional, Gea, Joachim, additional, Mccord, James, additional, Nowak, Richard, additional, Body, Richard, additional, deFilippi, Christopher R., additional, Christenson, Robert H., additional, Panteghini, Mauro, additional, Plebani, Mario, additional, Verschuren, Franck, additional, French, John, additional, Weiser, Silvia, additional, and Jernberg, Tomas, additional

Published
2021
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20. Syndrome of inappropriate antidiuretic hormone secretion and hypothalamic hypocortisolism in neuromyelitis optica

Author

Tsagkas, Charidimos, primary, Schäfer, Silke, additional, Baumgartner, Annette, additional, Müller, Jannis, additional, Sinnecker, Tim, additional, Mehling, Matthias, additional, van der Stouwe, Jan Gerrit, additional, Felder, Susan, additional, Panagiotou, Anneza, additional, Potlukova, Eliska, additional, Winzeler, Bettina, additional, Scholz, Marleen Carina, additional, Timper, Katharina, additional, Blackham, Kristine, additional, Nickel, Christian H, additional, Christ-Crain, Mirjam, additional, Bingisser, Roland, additional, Lyrer, Philippe, additional, Kappos, Ludwig, additional, and Yaldizli, Özgür, additional

Published
2021
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21. Impact of SARS-CoV-2 Lockdown on Glycaemic Control: A Retrospective Observational Cohort Study in a Tertiary Setting

Author

Zechmann, Stefan; https://orcid.org/0000-0001-5012-0068, Hotz, Leana, Di Gangi, Stefania, Baumgartl, Klaus, Plate, Andreas; https://orcid.org/0000-0001-6143-5479, Potlukova, Eliska; https://orcid.org/0000-0003-4790-8860, Zechmann, Stefan; https://orcid.org/0000-0001-5012-0068, Hotz, Leana, Di Gangi, Stefania, Baumgartl, Klaus, Plate, Andreas; https://orcid.org/0000-0001-6143-5479, and Potlukova, Eliska; https://orcid.org/0000-0003-4790-8860

Abstract

We analysed the effects of Swiss national lockdown due to the COVID-19 pandemic on the glycaemic control in patients with diabetes mellitus. In a retrospective observational cohort study with observation period 16 December 2018–27 July 2020, we included tertiary care patients with diabetes and at least one glycated haemoglobin A1c (HbA1c) measurement before and after the lockdown beginning. Main outcome measure was change in HbA1c after the lockdown. We included 1078 patients (86% diabetes type 2) with a mean HbA1c of 55.63 mmol/mol (7.24%). Glycaemic control was susceptible to seasonal changes with higher mean HbA1c in winter as compared to spring (57.49 mmol/mol (7.41%) vs. 55.52 mmol/mol (7.23%), p = 0.013). The lockdown did not affect the mean HbA1c values of all patients. However, we found a higher proportion of type 2 diabetes patients with a worsening HbA1c after the lockdown as compared to the year before (32% vs. 22.9%, p = 0.02). In a mixed-model regression multivariable analysis, inappropriate alcohol intake and hypothyroidism were associated with an increase in HbA1c after the lockdown. In conclusion, the national lockdown had no effect on overall mean HbA1c values but affected a proportion of type 2 diabetes patients with worsening HbA1c, whose individual risk factors were identified.

Published
2021

24. External Validation of the No Objective Testing Rules in Acute Chest Pain

Author

Ratmann, Paul David, primary, Boeddinghaus, Jasper, additional, Nestelberger, Thomas, additional, Lopez‐Ayala, Pedro, additional, Koechlin, Luca, additional, Wildi, Karin, additional, Miro, Oscar, additional, Martín‐Sánchez, F. Javier, additional, Christ, Michael, additional, Twerenbold, Raphael, additional, Rubini Gimenez, Maria, additional, Keller, Dagmar I., additional, Mueller, Christian, additional, Troester, Valentina, additional, Meier, Mario, additional, Puelacher, Christian, additional, du Fay de Lavallaz, Jeanne, additional, Potlukova, Eliska, additional, Badertscher, Patrick, additional, Arslani, Ketina, additional, Freese, Michael, additional, Michou, Eleni, additional, Flores, Dayana, additional, Lohrmann, Jens, additional, Rentsch, Katharina, additional, Reichlin, Tobias, additional, López, Beatriz, additional, Fuenzalida, Carolina, additional, Rodriguez Adrada, Esther, additional, Ganovská, Eva, additional, Parenica, Jiri, additional, von Eckardstein, Arnold, additional, Morawiec, Beata, additional, Kawecki, Damian, additional, Muzyk, Piotr, additional, Bürgler, Franz, additional, and Geigy, Nicolas, additional

Published
2021
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26. Early diagnosis of myocardial infarction with point-of-care high-sensitivity cardiac troponin I.

Author

Boeddinghaus, Jasper, Nestelberger, Thomas, Koechlin, Luca, Wussler, Desiree, Lopez-Ayala, Pedro, Walter, Joan Elias, Troester, Valentina, Ratmann, Paul David, Seidel, Funda, Zimmermann, Tobias, Badertscher, Patrick, Wildi, Karin, Rubini Giménez, Maria, Potlukova, Eliska, Strebel, Ivo, Freese, Michael, Miró, Òscar, Martin-Sanchez, F Javier, Kawecki, Damian, Keller, Dagmar I, Gualandro, Danielle M, Christ, Michael, Twerenbold, Raphael, Mueller, Christian, APACE Investigators, Boeddinghaus, Jasper, Nestelberger, Thomas, Koechlin, Luca, Wussler, Desiree, Lopez-Ayala, Pedro, Walter, Joan Elias, Troester, Valentina, Ratmann, Paul David, Seidel, Funda, Zimmermann, Tobias, Badertscher, Patrick, Wildi, Karin, Rubini Giménez, Maria, Potlukova, Eliska, Strebel, Ivo, Freese, Michael, Miró, Òscar, Martin-Sanchez, F Javier, Kawecki, Damian, Keller, Dagmar I, Gualandro, Danielle M, Christ, Michael, Twerenbold, Raphael, Mueller, Christian, and APACE Investigators

Abstract

BACKGROUND: Until now, high-sensitivity cardiac troponin (hs-cTn) assays were mainly developed for large central laboratory platforms. OBJECTIVES: This study aimed to assess the clinical performance of a point-of-care (POC)-hs-cTnI assay in patients with suspected myocardial infarction (MI). METHODS: This study enrolled patients presenting to the emergency department with symptoms suggestive of MI. Two cardiologists centrally adjudicated the final diagnosis using all clinical data including cardiac imaging. The primary objective was to directly compare diagnostic accuracy of POC-hs-cTnI-TriageTrue versus best-validated central laboratory assays. Secondary objectives included the derivation and validation of a POC-hs-cTnI-TriageTrue-specific 0/1-h algorithm. RESULTS: MI was the adjudicated final diagnosis in 178 of 1,261 patients (14%). The area under the curve (AUC) for POC-hs-cTnI-TriageTrue at presentation was 0.95 (95% confidence interval [CI]: 0.93 to 0.96) and was at least comparable to hs-cTnT-Elecsys (AUC: 0.94; 95% CI: 0.93 to 0.96; p = 0.213) and hs-cTnI-Architect (AUC: 0.92; 95% CI: 0.90 to 0.93; p < 0.001). A single cutoff concentration <3 ng/l at presentation identified 45% of patients at low risk with a negative predictive value (NPV) of 100% (95% CI: 99.4% to 100%). A single cutoff concentration >60 ng/l identified patients at high risk with a positive predictive value (PPV) of 76.8% (95% CI: 68.9% to 83.6%). The 0/1-h algorithm ruled out 55% of patients (NPV: 100%; 95% CI: 98.8% to 100%), and ruled in 18% of patients (PPV: 76.8%; 95% CI: 67.2% to 84.7%). Ruled-out patients had cumulative event rates of 0% at 30 days and 1.6% at 2 years. This study confirmed these findings in a secondary analysis including hs-cTnI-Architect for central adjudication. CONCLUSIONS: The POC-hs-cTnI-TriageTrue assay provides high diagnostic accuracy in patients with suspected MI with a clinical performance that is at least comparable to that of best-validated central labora

Published
2020

31. Early Diagnosis of Myocardial Infarction in Patients With a History of Coronary Artery Bypass Grafting

Author

Reichlin, Tobias, Zimmermann, Tobias, Meier, Mario, Troester, Valentina, Huber, Jeffrey, Christ, Michael, Badertscher, Patrick, Wildi, Karin, Puelacher, Christian, du Fay de Lavallaz, Jeanne, Giménez, Maria Rubini, Strebel, Ivo, Kozhuharov, Nikola, Gualandro, Danielle M., Potlukova, Eliska, Rentsch, Katharina, Miró, Òscar, Fuenzalida, Carolina, Shrestha, Samyut, Kawecki, Damian, Morawiec, Beata, Munzk, Piotr, Breidthardt, Tobias, Flores, Dayana, Freese, Michael, Stelzig, Claudia, Kulangara, Caroline, Meissner, Kathrin, Fahrni, Gregor, Michou, Eleni, Osswald, Stefan, Jeger, Raban, Kaiser, Christoph, López, Beatriz, Calderón, Sofia, Adrada, Esther Rodriguez, Ganovská, Eva, Parenica, Jiri, von Eckardstein, Arnold, Campodarve, Isabel, Gea, Joachim, Reuthebuch, Oliver, Grapow, Martin, Eckstein, Friedrich, Koechlin, Luca, Boeddinghaus, Jasper, Nestelberger, Thomas, Wussler, Desiree, Walter, Joan, Martin-Sanchez, F. Javier, Geigy, Nicolas, Keller, Dagmar I., Twerenbold, Raphael, and Mueller, Christian

Published
2019
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32. Effect of a Proposed Modification of the Type 1 and Type 2 Myocardial Infarction Definition on Incidence and Prognosis

Author

Schoepfer, Hadrien, primary, Nestelberger, Thomas, additional, Boeddinghaus, Jasper, additional, Twerenbold, Raphael, additional, Lopez-Ayala, Pedro, additional, Koechlin, Luca, additional, Wussler, Desiree, additional, Zimmermann, Tobias, additional, Miro, Oscar, additional, Martín-Sánchez, Javier F., additional, Christ, Michael, additional, Keller, Dagmar I., additional, Rubini Gimenez, Maria, additional, Mueller, Christian, additional, Gualandro, Danielle M., additional, Arslani, Ketina, additional, Ratmann, Paul David, additional, Hillinger, Petra, additional, Meier, Mario, additional, Coscia, Tania, additional, Freese, Michael, additional, Walter, Joan Elias, additional, Troester, Valentina, additional, Glarner, Noemi, additional, Puelacher, Christian, additional, Badertscher, Patrick, additional, Wildi, Karin, additional, Potlukova, Eliska, additional, Kawecki, Damian, additional, Morawiec, Beata, additional, Buergler, Franz, additional, Geigy, Nicolas, additional, and Reichlin, Tobias, additional

Published
2020
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35. Early Diagnosis of Myocardial Infarction With Point-of-Care High-Sensitivity Cardiac Troponin I

Author

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

Published
2020
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36. Clinical Use of a New High-Sensitivity Cardiac Troponin I Assay in Patients with Suspected Myocardial Infarction

Author

Boeddinghaus, Jasper, Twerenbold, Raphael, Nestelberger, Thomas, Koechlin, Luca, Wussler, Desiree, Meier, Mario, Troester, Valentina, Zimmermann, Tobias, Badertscher, Patrick, Wildi, Karin, Rubini Giménez, Maria, Lopez-Ayala, Pedro, Potlukova, Eliska, Miró, Òscar, Martin-Sanchez, F Javier, Kawecki, Damian, Geigy, Nicolas, Keller, Dagmar I, Reichlin, Tobias, and Mueller, Christian

Subjects
cardiovascular system, cardiovascular diseases, macromolecular substances, musculoskeletal system, 610 Medicine & health
Abstract

BACKGROUND We aimed to validate the clinical performance of the high-sensitivity cardiac troponin I [VITROS® Immunodiagnostic Products hs Troponin I (hs-cTnI-VITROS)] assay. METHODS We enrolled patients presenting to the emergency department with symptoms suggestive of acute myocardial infarction (AMI). Final diagnoses were centrally adjudicated by 2 independent cardiologists considering all clinical information, including cardiac imaging: first, using serial hs-cTnT-Elecsys (primary analysis) and, second, using hs-cTnI-Architect (secondary analysis) measurements in addition to the clinically used (hs)-cTn. hs-cTnI-VITROS was measured at presentation and at 1 h in a blinded fashion. The primary objective was direct comparison of diagnostic accuracy as quantified by the area under the ROC curve (AUC) of hs-cTnI-VITROS vs hs-cTnT-Elecsys and hs-cTnI-Architect, and in a subgroup also hs-cTnI-Centaur and hs-cTnI-Access. Secondary objectives included the derivation and validation of an hs-cTnI-VITROS-0/1-h algorithm. RESULTS AMI was the adjudicated final diagnosis in 158 of 1231 (13%) patients. At presentation, the AUC for hs-cTnI-VITROS was 0.95 (95% CI, 0.93-0.96); for hs-cTnT-Elecsys, 0.94 (95% CI, 0.92-0.95); and for hs-cTnI-Architect, 0.92 (95% CI, 0.90-0.94). AUCs for hs-cTnI-Centaur and hs-cTnI-Access were 0.95 (95% CI, 0.94-0.97). Applying the derived hs-cTnI-VITROS-0/1-h algorithm (derivation cohort n = 519) to the validation cohort (n = 520), 53% of patients were ruled out [sensitivity, 100% (95% CI, 94.1-100)] and 14% of patients were ruled in [specificity, 95.6% (95% CI, 93.4-97.2)]. Patients ruled out by the 0/1-h algorithm had a survival rate of 99.8% at 30 days. Findings were confirmed in the secondary analyses using the adjudication including serial measurements of hs-cTnI-Architect. CONCLUSIONS The hs-cTnI-VITROS assay has at least comparable diagnostic accuracy with the currently best validated hs-cTnT and hs-cTnI assays. CLINICALTRIALSGOV IDENTIFIER NCT00470587.

Published
2019
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38. Two-hour algorithm for rapid triage of suspected acute myocardial infarction using a high-sensitivity cardiac troponin I assay

Author

Nestelberger, Thomas, Boeddinghaus, Jasper, Greenslade, Jaimi, Parsonage, William A., Than, Martin, Wussler, Desiree, Lopez-Ayala, Pedro, Zimmermann, Tobias, Meier, Mario, Troester, Valentina, Badertscher, Patrick, Koechlin, Luca, Wildi, Karin, Anwar, Mahnoor, Freese, Michael, Keller, Dagmar I., Reichlin, Tobias, Twerenbold, Raphael, Cullen, Louise, Mueller, Christian, Puelacher, Christian, Du Fay De Lavallaz, Jeanne, Giménez, Maria Rubini, Strebel, Ivo, Walter, Joan, Huber, Jeffrey, Christ, Michael, Kozhuharov, Nikola, Gualandro, Danielle M., Potlukova, Eliska, Baumgartner, Benjamin, Hafner, Benjamin, Rent-Sch, Katharina, Miró, Òscar, Fuenzalida, Carolina, Gil, Beatriz, Javier Martin-Sanchez, F., Kawecki, Damian, Geigy, Nicolas, Meissner, Kathrin, Kulangara, Caroline, López, Beatriz, Adrada, Esther Rodriguez, Ganovská, Eva, Lohrmann, Jens, Kloos, Wanda, Steude, Jana, Buser, Andreas, Von Eckardstein, Arnold, Nowalany-Kozielska, Ewa, Muzyk, Piotr, Nestelberger, Thomas, Boeddinghaus, Jasper, Greenslade, Jaimi, Parsonage, William A., Than, Martin, Wussler, Desiree, Lopez-Ayala, Pedro, Zimmermann, Tobias, Meier, Mario, Troester, Valentina, Badertscher, Patrick, Koechlin, Luca, Wildi, Karin, Anwar, Mahnoor, Freese, Michael, Keller, Dagmar I., Reichlin, Tobias, Twerenbold, Raphael, Cullen, Louise, Mueller, Christian, Puelacher, Christian, Du Fay De Lavallaz, Jeanne, Giménez, Maria Rubini, Strebel, Ivo, Walter, Joan, Huber, Jeffrey, Christ, Michael, Kozhuharov, Nikola, Gualandro, Danielle M., Potlukova, Eliska, Baumgartner, Benjamin, Hafner, Benjamin, Rent-Sch, Katharina, Miró, Òscar, Fuenzalida, Carolina, Gil, Beatriz, Javier Martin-Sanchez, F., Kawecki, Damian, Geigy, Nicolas, Meissner, Kathrin, Kulangara, Caroline, López, Beatriz, Adrada, Esther Rodriguez, Ganovská, Eva, Lohrmann, Jens, Kloos, Wanda, Steude, Jana, Buser, Andreas, Von Eckardstein, Arnold, Nowalany-Kozielska, Ewa, and Muzyk, Piotr

Abstract

BACKGROUND We aimed to derive and externally validate a 0/2-h algorithm using the high-sensitivity cardiac troponin I (hs-cTnI)-Access assay. METHODS We enrolled patients presenting to the emergency department with symptoms suggestive of acute myocardial infarction (AMI) in 2 prospective diagnostic studies using central adjudication. Two independent cardiologists adjudicated the final diagnosis, including all available medical information including cardiac imaging. hs-cTnI-Access concentrations were measured at presentation and after 2 h in a blinded fashion. RESULTS AMI was the adjudicated final diagnosis in 164 of 1131 (14.5%) patients in the derivation cohort. Rule-out by the hs-cTnI-Access 0/2-h algorithm was defined as 0-h hs-cTnI-Access concentration <4 ng/L in patients with an onset of chest pain >3 h (direct rule-out) or a 0-h hs-cTnI-Access concentration <5 ng/L and an absolute change within 2 h <5 ng/L in all other patients. Derived thresholds for rule-in were a 0-h hs-cTnI-Access concentration ≥50 ng/L (direct rule-in) or an absolute change within 2 h ≥20 ng/L. In the derivation cohort, these cutoffs ruled out 55% of patients with a negative predictive value (NPV) of 99.8% (95% CI, 99.3–100) and sensitivity of 99.4% (95% CI, 96.5–99.9), and ruled in 30% of patients with a positive predictive value (PPV) of 73% (95% CI, 66.1–79). In the validation cohort, AMI was the adjudicated final diagnosis in 88 of 1280 (6.9%) patients. These cutoffs ruled out 77.9% of patients with an NPV of 99.8% (95% CI, 99.3–100) and sensitivity of 97.7% (95% CI, 92.0–99.7), and ruled in 5.8% of patients with a PPV of 77% (95% CI, 65.8–86) in the validation cohort. CONCLUSIONS Safety and efficacy of the l hs-cTnI-Access 0/2-h algorithm for triage toward rule-out or rule-in of AMI are very high.

Published
2019

39. Predicting acute myocardial infarction with a single blood draw

Author

Boeddinghaus, Jasper, Nestelberger, Thomas, Badertscher, Patrick, Twerenbold, Raphael, Fitze, Brigitte, Wussler, Desiree, Strebel, Ivo, Rubini Giménez, Maria, Wildi, Karin, Puelacher, Christian, du Fay de Lavallaz, Jeanne, Oehen, Loris, Walter, Joan, Miró, Òscar, Martin-Sanchez, F Javier, Morawiec, Beata, Potlukova, Eliska, Keller, Dagmar I, Reichlin, Tobias, Mueller, Christian, APACE Investigators, Boeddinghaus, Jasper, Nestelberger, Thomas, Badertscher, Patrick, Twerenbold, Raphael, Fitze, Brigitte, Wussler, Desiree, Strebel, Ivo, Rubini Giménez, Maria, Wildi, Karin, Puelacher, Christian, du Fay de Lavallaz, Jeanne, Oehen, Loris, Walter, Joan, Miró, Òscar, Martin-Sanchez, F Javier, Morawiec, Beata, Potlukova, Eliska, Keller, Dagmar I, Reichlin, Tobias, Mueller, Christian, and APACE Investigators

Abstract

BACKGROUND: We desired to determine cardiac troponin (cTn) concentrations necessary to achieve a positive predictive value (PPV) of ≥75% for acute myocardial infarction (AMI) to justify immediate admission of patients to a monitored unit and, in general, early coronary angiography. METHODS: In a prospective multicenter diagnostic study enrolling patients presenting to the emergency department with symptoms suggestive of AMI, final diagnoses were adjudicated by 2 independent cardiologists based on clinical information including cardiac imaging. cTn concentrations were measured using 5 different sensitive and high-sensitivity cTn (hs-cTn) assays in a blinded fashion at presentation and serially thereafter. The diagnostic end point was PPV for rule-in of AMI of initial cTn concentrations alone and in combination with early changes. RESULTS: Among 3828 patients, 616 (16%) had an AMI. At presentation, 7% to 14% of patients had cTnT/I concentrations associated with a PPV of ≥75%. Adding absolute or relative changes did not significantly further increase the PPV. PPVs increased from 46.5% (95% CI, 43.6-49.4) for hs-cTnT at presentation >14 ng/L to 78.9% (95% CI, 74.7-82.5) for >52 ng/L (P < 0.001), whereas PPVs in higher hs-cTnT strata remained largely unchanged [e.g., 82.4% (95% CI, 77.5-86.7) for >80 ng/L vs 83.9% (95% CI, 76.0-90.1) for >200 ng/L (P = 0.72)]. The addition of early changes in hs-cTnT further increased the PPV up to 60 ng/L, but not for higher concentrations. CONCLUSIONS: Serial sampling does not seem necessary for predicting AMI and concurrent decision-making in about 10% of patients, as it only marginally increases the PPV for AMI and not in a statistically or clinically significant way. CLINICALTRIALSGOV IDENTIFIER: NCT00470587.

Published
2019

40. Impact of age on the performance of the ESC 0/1h-algorithms for early diagnosis of myocardial infarction

Author

Boeddinghaus, Jasper, Nestelberger, Thomas, Twerenbold, Raphael, et al, Badertscher, Patrick, Jann, Janina E, Wussler, Desiree, Puelacher, Christian, Rubini Giménez, Maria, Wildi, Karin, Strebel, Ivo, Du Fay de Lavallaz, Jeanne, Selman, Farah, Sabti, Zaid, Kozhuharov, Nikola, Potlukova, Eliska, Rentsch, Katharina, Lohrmann, Jens, Kloos, Wanda, Buser, Andreas, Geigy, Nicolas, Keller, Dagmar I, Osswald, Stefan, Reichlin, T, Mueller, Christian, University of Zurich, and Mueller, Christian

Subjects
540 Chemistry, 610 Medicine & health, 2705 Cardiology and Cardiovascular Medicine, 10038 Institute of Clinical Chemistry
Published
2018

41. Two-Hour Algorithm for Rapid Triage of Suspected Acute Myocardial Infarction Using a High-Sensitivity Cardiac Troponin I Assay

Author

Nestelberger, Thomas, primary, Boeddinghaus, Jasper, additional, Greenslade, Jaimi, additional, Parsonage, William A, additional, Than, Martin, additional, Wussler, Desiree, additional, Lopez-Ayala, Pedro, additional, Zimmermann, Tobias, additional, Meier, Mario, additional, Troester, Valentina, additional, Badertscher, Patrick, additional, Koechlin, Luca, additional, Wildi, Karin, additional, Anwar, Mahnoor, additional, Freese, Michael, additional, Keller, Dagmar I, additional, Reichlin, Tobias, additional, Twerenbold, Raphael, additional, Cullen, Louise, additional, Mueller, Christian, additional, Puelacher, Christian, additional, du Fay de Lavallaz, Jeanne, additional, Rubini Giménez, Maria, additional, Strebel, Ivo, additional, Walter, Joan, additional, Huber, Jeffrey, additional, Christ, Michael, additional, Kozhuharov, Nikola, additional, Gualandro, Danielle M, additional, Potlukova, Eliska, additional, Baumgartner, Benjamin, additional, Hafner, Benjamin, additional, Rentsch, Katharina, additional, Miró, Òscar, additional, Fuenzalida, Carolina, additional, Gil, Beatriz, additional, Martin-Sanchez, F Javier, additional, Kawecki, Damian, additional, Geigy, Nicolas, additional, Meissner, Kathrin, additional, Kulangara, Caroline, additional, López, Beatriz, additional, Rodriguez Adrada, Esther, additional, Ganovská, Eva, additional, Lohrmann, Jens, additional, Kloos, Wanda, additional, Steude, Jana, additional, Buser, Andreas, additional, von Eckardstein, Arnold, additional, Nowalany-Kozielska, Ewa, additional, and Muzyk, Piotr, additional

Published
2019
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42. 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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43. 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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44. Early Diagnosis of Myocardial Infarction in Patients With a History of Coronary Artery Bypass Grafting

Author

Koechlin, Luca, primary, Boeddinghaus, Jasper, additional, Nestelberger, Thomas, additional, Wussler, Desiree, additional, Walter, Joan, additional, Martin-Sanchez, F. Javier, additional, Geigy, Nicolas, additional, Keller, Dagmar I., additional, Twerenbold, Raphael, additional, Mueller, Christian, additional, Reichlin, Tobias, additional, Zimmermann, Tobias, additional, Meier, Mario, additional, Troester, Valentina, additional, Huber, Jeffrey, additional, Christ, Michael, additional, Badertscher, Patrick, additional, Wildi, Karin, additional, Puelacher, Christian, additional, du Fay de Lavallaz, Jeanne, additional, Giménez, Maria Rubini, additional, Strebel, Ivo, additional, Kozhuharov, Nikola, additional, Gualandro, Danielle M., additional, Potlukova, Eliska, additional, Rentsch, Katharina, additional, Miró, Òscar, additional, Fuenzalida, Carolina, additional, Shrestha, Samyut, additional, Kawecki, Damian, additional, Morawiec, Beata, additional, Munzk, Piotr, additional, Breidthardt, Tobias, additional, Flores, Dayana, additional, Freese, Michael, additional, Stelzig, Claudia, additional, Kulangara, Caroline, additional, Meissner, Kathrin, additional, Fahrni, Gregor, additional, Michou, Eleni, additional, Osswald, Stefan, additional, Jeger, Raban, additional, Kaiser, Christoph, additional, López, Beatriz, additional, Calderón, Sofia, additional, Adrada, Esther Rodriguez, additional, Ganovská, Eva, additional, Parenica, Jiri, additional, von Eckardstein, Arnold, additional, Campodarve, Isabel, additional, Gea, Joachim, additional, Reuthebuch, Oliver, additional, Grapow, Martin, additional, and Eckstein, Friedrich, additional

Published
2019
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45. High-Sensitivity Cardiac Troponin I Assay for Early Diagnosis of Acute Myocardial Infarction

Author

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

Published
2019
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46. Impact of age on the performance of the ESC 0/1h-algorithms for early diagnosis of myocardial infarction.

Author

UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - (SLuc) Service des urgences, Boeddinghaus, Jasper, Nestelberger, Thomas, Twerenbold, Raphael, Neumann, Johannes Tobias, Lindahl, Bertil, Giannitsis, Evangelos, Sörensen, Nils Arne, Badertscher, Patrick, Jann, Janina E, Wussler, Desiree, Puelacher, Christian, Rubini Giménez, Maria, Wildi, Karin, Strebel, Ivo, Du Fay de Lavallaz, Jeanne, Selman, Farah, Sabti, Zaid, Kozhuharov, Nikola, Potlukova, Eliska, Rentsch, Katharina, Miró, Òscar, Martin-Sanchez, F Javier, Morawiec, Beata, Parenica, Jiri, Lohrmann, Jens, Kloos, Wanda, Buser, Andreas, Geigy, Nicolas, Keller, Dagmar I, Osswald, Stefan, Reichlin, Tobias, Westermann, Dirk, Blankenberg, Stefan, Mueller, Christian, APACE, BACC, and TRAPID-AMI Investigators, Verschuren, Franck, UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - (SLuc) Service des urgences, Boeddinghaus, Jasper, Nestelberger, Thomas, Twerenbold, Raphael, Neumann, Johannes Tobias, Lindahl, Bertil, Giannitsis, Evangelos, Sörensen, Nils Arne, Badertscher, Patrick, Jann, Janina E, Wussler, Desiree, Puelacher, Christian, Rubini Giménez, Maria, Wildi, Karin, Strebel, Ivo, Du Fay de Lavallaz, Jeanne, Selman, Farah, Sabti, Zaid, Kozhuharov, Nikola, Potlukova, Eliska, Rentsch, Katharina, Miró, Òscar, Martin-Sanchez, F Javier, Morawiec, Beata, Parenica, Jiri, Lohrmann, Jens, Kloos, Wanda, Buser, Andreas, Geigy, Nicolas, Keller, Dagmar I, Osswald, Stefan, Reichlin, Tobias, Westermann, Dirk, Blankenberg, Stefan, Mueller, Christian, APACE, BACC, and TRAPID-AMI Investigators, and Verschuren, Franck

Abstract

AIMS: We aimed to evaluate the impact of age on the performance of the European Society of Cardiology (ESC) 0/1h-algorithms and to derive and externally validate alternative cut-offs specific to older patients. METHODS AND RESULTS: We prospectively enrolled patients presenting to the emergency department (ED) with symptoms suggestive of acute myocardial infarction in three large diagnostic studies. Final diagnoses were adjudicated by two independent cardiologists. High-sensitivity cardiac troponin (hs-cTn) T and I concentrations were measured at presentation and after 1 h. Patients were stratified according to age [<55 years (young), ≥55 to <70 years (middle-age), ≥70 years (old)]. Rule-out safety of the ESC hs-cTnT 0/1h-algorithm was very high in all age-strata: sensitivity 100% [95% confidence interval (95% CI) 94.9-100] in young, 99.3% (95% CI 96.0-99.9) in middle-age, and 99.3% (95% CI 97.5-99.8) in old patients. Accuracy of rule-in decreased with age: specificity 97.0% (95% CI 95.8-97.9) in young, 96.1% (95% CI 94.5-97.2) in middle-age, and 92.7% (95% CI 90.7-94.3) in older patients. Triage efficacy decreased with increasing age (young 93%, middle-age 80%, old 55%, P < 0.001). Similar results were found for the ESC hs-cTnT 0/1h-algorithm. Alternative, slightly higher cut-off concentrations optimized for older patients maintained very high safety of rule-out, increased specificity of rule-in (P < 0.01), reduced overall efficacy for hs-cTnT (P < 0.01), while maintaining efficacy for hs-cTnI. Findings were confirmed in two validation cohorts (n = 2767). CONCLUSION: While safety of the ESC 0/1h-algorithms remained very high, increasing age significantly reduced overall efficacy and the accuracy of rule-in. Alternative slightly higher cut-off concentrations may be considered for older patients, particularly if using hs-cTnI. CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/ct2/show/NCT00470587, number NCT00470587 and NCT02355457 (BACC).

Published
2018

47. High prevalence of anti-C1q antibodies in biopsy-proven active lupus nephritis

Author

Trendelenburg, Marten, Lopez-Trascasa, Margarita, Potlukova, Eliska, Moll, Solange, Regenass, Stephan, Frémeaux-Bacchi, Véronique, Martinez-Ara, Jorge, Jancova, Eva, Picazo, Mari Luz, Honsova, Eva, Tesar, Vladimir, Sadallah, Salima, Schifferli, Jürg, Trendelenburg, Marten, Lopez-Trascasa, Margarita, Potlukova, Eliska, Moll, Solange, Regenass, Stephan, Frémeaux-Bacchi, Véronique, Martinez-Ara, Jorge, Jancova, Eva, Picazo, Mari Luz, Honsova, Eva, Tesar, Vladimir, Sadallah, Salima, and Schifferli, Jürg

Abstract

Background. Anti-C1q antibodies (anti-C1q) have been shown to correlate positively with systemic lupus erythematosus (SLE) nephritis. Several clinical studies indicated a high negative predictive value, suggesting that active lupus nephritis is rarely seen in patients with no anti-C1q. However, the true prevalence of anti-C1q at the time of active lupus nephritis has not been well established. The aim of this study was to determine prospectively the prevalence of anti-C1q in proven active lupus nephritis at the time of the renal biopsy. Methods. In this prospective multi-centre study, we investigated adult SLE patients undergoing renal biopsy for suspected active lupus nephritis. Serum samples were taken at the time of the biopsy and analysed for the presence of anti-C1q in a standardized way. The activity of lupus nephritis was classified according to the renal histology. Biopsies were also analysed for the presence of glomerular IgG, C1q and C3 deposition. Results. A total of 38 patients fulfilling at least 4/11 American College of Rheumatology (ACR) criteria for the diagnosis of SLE were included. Out of this, 36 patients had proliferative (class II, III or IV) and two had class V lupus nephritis. All but one patient with proliferative lupus nephritis were positive for anti-C1q (97.2%) compared with the 35% of control SLE patients with inactive lupus nephritis and 25% of SLE patients without lupus nephritis ever. All patients were positive for glomerular C1q (36/36) and 37/38 patients had glomerular IgG deposits. Anti-C1q strongly decreased during successful treatment. Conclusions. Anti-C1q have a very high prevalence in biopsy-proven active lupus nephritis, thus a negative test result almost excludes active nephritis. The data support the hypothesis of a pathogenic role of anti-C1q in lupus nephritis

Published
2017

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