Evidence map›Paper›PMID 28331988›Full record

ArticleClinical research in cardiology : official journal of the German Cardiac Society2017

Point-of-care testing of cardiac autonomic function for risk assessment in patients with suspected acute coronary syndromes.

C Eick, M Duckheim, P Groga-Bada, N Klumpp, S Mannes, C S Zuern, M Gawaz, K D Rizas, Axel Bauer

Registry-linked trialAbstract read
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In one paragraph

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. It is linked to trial NCT01486589 (Risk Stratification in the Emergency Room by Cardiac Autonomic Function), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01486589 completednot on this map

Risk Stratification in the Emergency Room by Cardiac Autonomic Function

TypeobservationalSponsorThebiosignals.comRan2010Enrolled6,521ConditionsAutonomic Nervous System Activity
3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. 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 · 2020
    Article
  3. Cardiac autonomic modulation impairments in advanced breast cancer patients.Clinical research in cardiology : official journal of the German Cardiac Society · 2018
    Article
  4. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

C EickMedizinische Klinik III, Eberhard-Karls-Universität Tübingen, Tübingen, Germany.
M DuckheimMedizinische Klinik III, Eberhard-Karls-Universität Tübingen, Tübingen, Germany.
P Groga-BadaMedizinische Klinik III, Eberhard-Karls-Universität Tübingen, Tübingen, Germany.
N KlumppMedizinische Klinik III, Eberhard-Karls-Universität Tübingen, Tübingen, Germany.
S MannesMedizinische Klinik III, Eberhard-Karls-Universität Tübingen, Tübingen, Germany.
C S ZuernMedizinische Klinik III, Eberhard-Karls-Universität Tübingen, Tübingen, Germany.
M GawazMedizinische Klinik III, Eberhard-Karls-Universität Tübingen, Tübingen, Germany.
K D RizasMedizinische Klinik und Poliklinik I, Munich University Clinic, Marchioninistr. 15, 81377, Munich, Germany.
Axel BauerMedizinische Klinik und Poliklinik I, Munich University Clinic, Marchioninistr. 15, 81377, Munich, Germany. axel.bauer@med.uni-muenchen.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundImpaired cardiac autonomic function has been linked to adverse outcomes in patients with acute coronary syndromes (ACS) but is not included in clinical risk models. This is the first study to investigate whether point-of-care testing of cardiac autonomic function by means of short-term deceleration capacity (DC) of heart rate improves risk assessment in patients with suspected ACS.

methods1821 patients with suspected ACS were prospectively enrolled if they were older than 17 years and in sinus rhythm. Short-term DC was automatically assessed from monitor recordings at hospital admission. The Global Registry of Acute Coronary Events (GRACE) score was used as gold standard risk predictor. Primary endpoint was the composite of intrahospital and 30-day mortality. Secondary endpoint was 180-day mortality.

resultsOf the 1,821 patients with suspected ACS, 28 (1.5%) and 60 (3.3%) reached the primary and secondary endpoints, respectively. DC was a highly significant predictor of both endpoints, yielding areas under the curve (AUC) of 0.784 (95% CI 0.714-0.854) and 0.781 (0.727-0.832) (p < 0.001 for both), respectively. Implementing DC into the GRACE-risk model leads to a significant increase of the C-statistics from 0.788 (0.703-0.874) to 0.825 (0.750-0.900; p < 0.01 for difference) and from 0.814 (0.759-0.864) to 0.851 (0.808-0.889; p < 0.01 for difference) for the primary and secondary endpoints, respectively. Stratification by dichotomized DC was especially powerful in patients with GRACE score <140.

conclusionsIn patients with suspected ACS, point-of-care testing of cardiac autonomic function by means of DC is feasible and improves risk assessment by the GRACE score. CLINICAL

trial registrationClinicaltrials.gov NCT01486589.

Indexed as

Point-of-Care TestingAcute Coronary SyndromeAdultAgedAutonomic Nervous SystemFeasibility StudiesFemaleHospitalizationHospital MortalityHumansMaleMiddle AgedProspective StudiesRisk AssessmentTime FactorsAcute coronary syndromeAutonomic nervous systemECGRisk stratification

Identifiers

PMID28331988

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.