ArticleClinical research in cardiology : official journal of the German Cardiac Society2014
Disease distribution and outcome in troponin-positive patients with or without revascularization in a chest pain unit: results of the German CPU-Registry.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Criteria of the German Society of Cardiology for the establishment of chest pain units: update 2014.Clinical research in cardiology : official journal of the German Cardiac Society · 2015Guideline
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- Prevalence and outcome of patients referred for chest pain with high-sensitivity troponin elevation and no diagnosis at discharge.Clinical cardiology · 2018Article
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- Cardiac computed tomography in patients with symptomatic new-onset atrial fibrillation, rule-out acute coronary syndrome, but with intermediate pretest probability for coronary artery disease admitted to a chest pain unit.European journal of medical research · 2018Article
- T1 and T2 mapping cardiovascular magnetic resonance imaging techniques reveal unapparent myocardial injury in patients with myocarditis.Clinical research in cardiology : official journal of the German Cardiac Society · 2017Article
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- Prevalence of thrombophilic disorders in takotsubo patients: the (ThROmbophylia in TAkotsubo cardiomyopathy) TROTA study.Clinical research in cardiology : official journal of the German Cardiac Society · 2016Article
- Article
- How rapid is rapid? Exemplary results of real-life rapid rule-out troponin timing in troponin-positive acute coronary syndromes without persistent ST-segment elevation in two contrasting German chest pain unit facilities.European journal of medical research · 2016Article
- Coronary Artery Calcium as an Independent Surrogate Marker in the Risk Assessment of Patients With Atrial Fibrillation and an Intermediate Pretest Likelihood for Coronary Artery Disease Admitted to a German Chest Pain Unit.Clinical cardiology · 2016Observational
- Frequency and covariates of fear of death during myocardial infarction and its impact on prehospital delay: findings from the multicentre MEDEA Study.Clinical research in cardiology : official journal of the German Cardiac Society · 2016Article
- Cardiac surgery 2014 reviewed.Clinical research in cardiology : official journal of the German Cardiac Society · 2015Review
- Coronary procedures in German hospitals: a detailed analysis for specific patient clusters.Clinical research in cardiology : official journal of the German Cardiac Society · 2015Article
- Anti-glioma action of aloe emodin: the role of ERK inhibition.Cellular and molecular life sciences : CMLS · 2005Article
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14 authors.
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Abstract
objectivesThe aim of this analysis was to compare troponin-positive patients presenting to a chest pain unit (CPU) and undergoing coronary angiography with or without subsequent revascularization. Leading diagnosis, disease distribution, and short-term outcomes were evaluated.
backgroundChest pain units are increasingly implemented to promptly clarify acute chest pain of uncertain origin, including patients with suspected acute coronary syndrome (ACS).
methodsA total of 11,753 patients were prospectively enrolled into the German CPU-Registry of the German Cardiac Society between December 2008 and April 2011. All patients with elevated troponin undergoing a coronary angiography were selected. Three months after discharge a follow-up was performed.
resultsA total of 2,218 patients were included. 1,613 troponin-positive patients (72.7 %) underwent a coronary angiography with subsequent PCI or CABG and had an ACS in 96.0 %. In contrast, 605 patients (27.3 %) underwent a coronary angiography without revascularization and had an ACS in 79.8 %. The most frequent non-coronary diagnoses in non-revascularized patients were acute arrhythmias (13.4 %), pericarditis/myocarditis (4.5 %), decompensated congestive heart failure (3.7 %), Takotsubo cardiomyopathy (2.7 %), hypertensive crisis (2.4 %), and pulmonary embolism (0.3 %). During the 3-month followup, patients without revascularization had a higher mortality (12.1 vs. 4.5 %, p<0.0001) representing the major contributor to the higher rate of MACCE (15.1 vs. 8.1 %, p<0.001). These data were confirmed in a subgroup analysis of ACS patients with or without revascularization.
conclusionsPatients presenting to a CPU with elevated troponin levels mostly suffer from ACS and in a smaller proportion a variety of different diseases are responsible. The short-term outcome in troponin-positive patients with or without an ACS not undergoing a revascularization was worse, indicating that these patients were more seriously ill than patients with revascularization of the culprit lesion. Therefore, an adequate diagnostic evaluation and improved treatment strategies are warranted.
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