von Rico Osteresch ; Andreas Fach ; Fabian-Simon Frielitz ; Sven Meyer ; Johannes Schmucker ; Stephan Rühle ; Tina Retzlaff ; Moritz Hadwiger ; Tobias Härle ; Albrecht Elsässer ; Alexander Katalinic ; Ingo Eitel ; Rainer Hambrecht ; Harm Wienbergen
von Jakob Lüker ; Kathrin Kuhr ; Arian Sultan ; Georg Nölker ; Omran Hazem ; Stephan Willems ; Rene Andrie ; Jan Wilko Schrickel ; Stefan Winter ; Dirk Vollmann ; Roland Tilz ; Alexander Jobs ; Christian-H. Heeger ; Andreas Metzner ; Sven Meyer ; Karl Mischke ; Nils Andreas Napp ; Andreas Fahrig ; Susanne Steinhauser ; Johannes Brachmann ; Stephan Baldus ; Rajiv Mahajan ; Prashanthan Sanders ; Daniel Steven
von Jakob Lüker ; Kathrin Kuhr ; Arian Sultan ; Georg Nölker ; Hazem Omran ; Stephan Willems ; Rene Andrie ; Jan Wilko Schrickel ; Stefan Winter ; Dirk Vollmann ; Roland R. Tilz ; Alexander Jobs ; Christian-H. Heeger ; Andreas Metzner ; Sven Meyer ; Karl-Ludwig Mischke ; Nils Andreas Napp ; Andreas Fahrig ; Susanne Steinhauser ; Johannes Brachmann ; Stephan Baldus ; Rajiv Mahajan ; Prashanthan Sanders ; Daniel Steven
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
von Bernadet T. Santema ; Wouter Ouwerkerk ; Jasper Tromp ; Iziah E. Sama ; Alice Ravera ; Vera Regitz-Zagrosek ; Hans Hillege ; Nilesh J. Samani ; Faiez Zannad ; Kenneth Dickstein ; Chim C. Lang ; John G. F. Cleland ; Jozine M. ter Maaten ; Marco Metra ; Stefan D. Anker ; Pim van der Harst ; Leong L. Ng ; Peter van der Meer ; Dirk J. van Veldhuisen ; Sven Meyer ; Carolin S. P. Lam
von Oliver Weingärtner ; Dieter Lütjohann ; Sven Meyer ; Arne Fuhrmann ; Bodo Cremers ; Sarah Seiler-Mußler ; Hans-F. Schött ; Anja Kerksiek ; Silvia Friedrichs ; Ursula Ulbricht ; Adam Zawada ; Ulrich Laufs ; Paul Christian Schulze ; Bruno Scheller ; Danilo Fliser ; Michael Böhm ; Eric Sijbrands ; Gunnar Henrik Heine
von Tobias Härle ; Mareike Luz ; Sven Meyer ; Felix Vahldiek ; Prim van der Harst ; Randy van Dijk ; Daan Ties ; Javier Escaned ; Justin Davies ; Albrecht Elsässer
von Harm Wienbergen ; Andreas Fach ; Sven Meyer ; Jochen Meyer ; Janina Stehmeier ; Tina Backhaus ; Stephan Michel ; Kirsten Krämer ; Rico Osteresch ; Johannes Schmucker ; Henning Haase ; Tobias Härle ; Albrecht Elsässer ; Rainer Hambrecht
