Available online 11 October 2018 ; Gesehen am 09.05.2019
ACS; Diagnosis; Prognosis; Sex difference; Troponin T
Introduction - Sex- and age-specific high-sensitivity Troponin T (hs-cTnT) cutpoints for the diagnosis and prognosis in acute coronary syndromes are not well established. We evaluated the use of such dichotomous thresholds for calculation of the GRACE score. - Methods - We analyzed a retrospective cohort study of 1146 patients with non-ST-elevation acute coronary syndrome (NSTE-ACS). Sex-dependent hs-cTnT cutpoints comprised 15.5ng/L for men and 9.0ng/L for women, while the sex-/age-specific cutpoints comprised 17ng/L for 50-64-year-old men and 65-year-old women, 31ng/L for 65-year-old men and 14ng/L for the remainder of patients. - Results - For the diagnosis of NSTEMI using sex-specific hs-cTnT cutpoints, in women, the positive likelihood ratio (LR+) was 2.04 (1.68-2.47) while in men, the negative likelihood ratio (LR) was 0.05 (0.04-0.07). Using sex-/age-specific hs-cTnT cutpoints, in 65-year-old women the LR was 0.09 (0.06-0.15), in 50 to 64-year-old men the LR was 0.08 (0.04-0.13) while in 65-year-old men the LR was 0.32 (0.28-0.37). Sex-specific hs-cTnT cutpoints achieved an NRI of 0.020 (95% CI, 0.101-0.118) for women and 0.030 (95% CI, 0.013-0.079) for men, and the sex-/age-specific hs-cTnT cutpoints achieved an NRI of 0.061 (95% CI, 0.019-0.132) for women and 0.021 (95% CI, 0.062-0.108) for men, while net benefit and clinical utility were highest for women using the sex-/age-specific hs-cTnT cutpoints. - Conclusions - Sex-dependent hs-cTNT cutpoints imply increasing diagnostic sensitivity for women at the cost of specificity. Considering age for hs-cTNT cutoffs slightly improves risk reclassification, although the overall gain in terms of the clinical management appears negligible.
International journal of cardiology Amsterdam [u.a.] : Elsevier Science, 1981 275(2019), Seite 13-19 Online-Ressource
Auch als elektronisches Dokument verfügbar: http://www.sfb580.uni-jena.de/typo3/uploads/tx_publicationlist/Heft41_02.pdf
Praktikum; Personalmanagement; Strategie; Flexibilität; Betriebliche Ausbildung; Anforderungsprofil; Absolventen; Deutschland
Der Wandel betrieblicher Personalpolitik in ausgewählten Arbeitsmarksegmenten und Auswirkungen auf individuelle Mobilität und Risiken Jena : Univ. Jena, SFB 580, 2012 (2012), Seite 25-50 109 S.