ArticleClinical research in cardiology : official journal of the German Cardiac Society2017
Early diagnosis of acute myocardial infarction in patients with mild elevations of cardiac troponin.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 49 citations in OpenAlex.
- Trial
- The Incremental Value of Copeptin for the Early Rule-Out of Non-ST Elevation Myocardial Infarction in the Emergency Department.Journal of clinical medicine · 2026Article
- Prognostic and functional role of PPAR-alpha and SNP receptor (Leu162Val) in acute coronary syndrome: a potential novel target.Journal, genetic engineering & biotechnology · 2025Article
- Diagnostic performance and risk assessment of combined copeptin and high-sensitivity cardiac troponin I in Chinese emergency department.International journal of cardiology. Heart & vasculature · 2025Article
- Copeptin in Acute Myocardial Infarction: Is There a Role in the Era of High-Sensitivity Troponins?Journal of cardiovascular development and disease · 2025Review
- The diagnostic and prognostic value of serum miR-199a-5p combined with echocardiography in acute myocardial infarction.Journal of cardiothoracic surgery · 2025Article
- Identifying potential drug targets for myocardial infarction through Mendelian randomization.PloS one · 2024Article
- Cost-Effective Fiber Optic Solutions for Biosensing.Biosensors · 2022Review
- Copeptin as a Diagnostic and Prognostic Biomarker in Cardiovascular Diseases.Frontiers in cardiovascular medicine · 2022Review
- Performance of Copeptin for Early Diagnosis of Acute Coronary Syndromes: A Systematic Review and Meta-Analysis of 14,139 Patients.Journal of cardiovascular development and disease · 2021Review
- Critical appraisal of the 2020 ESC guideline recommendations on diagnosis and risk assessment in patients with suspected non-ST-segment elevation acute coronary syndrome.Clinical research in cardiology : official journal of the German Cardiac Society · 2021Article
- Biosensing based on field-effect transistors (FET): Recent progress and challenges.Trends in analytical chemistry : TRAC · 2020Review
- High-Sensitivity Troponin T Testing: Consequences on Daily Clinical Practice and Effects on Diagnosis of Myocardial Infarction.Journal of clinical medicine · 2020Article
- FIFA World Cup 2018: effect of emotional stress on conventional heart rate variability metrics.Clinical research in cardiology : official journal of the German Cardiac Society · 2020Article
- The Biomarkers for Acute Myocardial Infarction and Heart Failure.BioMed research international · 2020Review
- Performance of Copeptin for Early Diagnosis of Acute Myocardial Infarction in an Emergency Department Setting.Annals of laboratory medicine · 2020Article
- Article
- Novel ECG-based scoring tool for prediction of takotsubo syndrome.Clinical research in cardiology : official journal of the German Cardiac Society · 2019Article
- 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.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2018Article
- Circadian rhythm of blood cardiac troponin T concentration.Clinical research in cardiology : official journal of the German Cardiac Society · 2017Article
Corrections and comments
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Authors and funding
37 authors at 8 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe early diagnosis of acute myocardial infarction (AMI) in patients with mild elevations of high-sensitivity cardiac troponin (hs-cTn) is a challenge. It is unclear whether copeptin, a marker of endogenous stress, or 1h-hs-cTn changes are better suited to address this important unmet clinical need.
methodsWe prospectively enrolled patients presenting with symptoms suggestive of AMI to the emergency department (ED). Two independent cardiologists adjudicated the final diagnosis. Mild hs-cTn elevations were defined as 26.2 ng/L (99th percentile) to 75 ng/L for hs-cTnI, and 14 ng/L (99th percentile) to 50 ng/L (biological-equivalent to 75 ng/L for hs-cTnI) for hs-cTnT.
resultsAmong 1356 patients, 80 (6%) had mild hs-cTnI elevations at presentation. Within this group, AMI was the final diagnosis in 39 patients (49%). The diagnostic accuracy for the diagnosis of AMI as quantified by the area under the receiver operating characteristic curve (AUC) was 0.51 (95% CI 0.39-0.64) for hs-cTnI at presentation, 0.58 (95% CI 0.45-0.71) for copeptin at presentation, and 0.78 (95% CI 0.68-0.88) for 1h-hs-cTnI changes, which was significantly higher as compared to copeptin (p = 0.02) or hs-cTnI alone (p < 0.001). The additional use of 1h-hs-cTnI changes, but not of copeptin, improved diagnostic accuracy of hs-cTnI at presentation (AUC 0.80, 95% CI 0.70-0.90; p = 0.002 for comparison). Similar findings regarding copeptin and 1h-hs-cTnT/I changes were obtained for mild hs-cTnT elevations.
conclusionsAbout 6-22% of patients presenting with suggestive AMI to the ED have mild hs-cTnT/I elevations at presentation. In contrast to copeptin, the addition of 1h-hs-cTn changes substantially improves the early diagnosis of AMI.
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