Evidence map›Paper›PMID 30773602›Full record

Observational studySingapore medical journal2019

High-sensitivity troponin T and long-term adverse cardiac events among patients presenting with suspected acute coronary syndrome in Singapore.

Ziwei Lin, Swee Han Lim, Siang Jin Terrance Chua, E Shyong Tai, Yiong Huak Chan, Arthur Mark Richards

Abstract readObservational Study
In one paragraph

Observational study in Singapore medical journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
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

6 authors.

Ziwei LinEmergency Medicine Department, National University Hospital, National University Health System, Singapore.
Swee Han LimDepartment of Emergency Medicine, Singapore General Hospital, Singapore.
Siang Jin Terrance ChuaDepartment of Cardiology, National Heart Centre Singapore, Singapore.
E Shyong TaiDivision of Endocrinology, National University Hospital, National University Health System, Singapore.
Yiong Huak ChanBiostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Arthur Mark RichardsChristchurch Heart Institute, Department of Medicine, University of Otago, New Zealand.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPrognostic thresholds for 30-day major adverse cardiac events (MACE) have been studied for high-sensitivity troponin T (hsTnT) in patients with suspected acute coronary syndrome (ACS), but there is limited data on the prognostic performance of hsTnT for one-year MACE.

methodsWe prospectively measured hsTnT (in ng/mL up to two decimal places) at 0, 2 and 7 hours for patients presenting with symptoms suggestive of ACS to our emergency department from March 2010 to April 2013. We assessed the prognostic performance of hsTnT cut-offs for 30-day and one-year MACE, and the utility of delta-hsTnT in predicting MACE.

resultsAmong 2,444 patients studied, 273 (11.2%) developed MACE (including index MACE) by 30 days and 359 (14.7%) patients developed MACE at one year. The suggested hsTnT cut-off for 30-day MACE was ≥ 10 ng/L at 0 hour (positive predictive value [PPV] 33.5%, negative predictive value [NPV] 94.5%) and 7 hours (PPV 37.3%, NPV 94.5%), and ≥ 20 ng/L at 2 hours (PPV 36.9%, NPV 96.9%). For one-year MACE, the suggested cut-off was also ≥ 10 ng/L at all readings. Plasma hsTnT ≥ 30 ng/L at any reading gave PPV > 54% and NPV > 93% for 30-day MACE. Absolute 0-2 hour and 2-7 hour delta-hsTnT ≥ 10 ng/L gave PPV > 50% for 30-day and one-year MACE.

conclusionPatients with 0-, 2- or 7-hour hsTnT ≥ 30 ng/L and 0-2 hour delta-hsTnT ≥ 10 ng/L had PPV > 50% for 30-day and one-year MACE, and should be investigated thoroughly.

Indexed as

Acute Coronary SyndromeBiomarkersCardiovascular DiseasesFemaleHumansMaleMiddle AgedPredictive Value of TestsPrognosisProspective StudiesSingaporeTroponin TBiomarkersTroponin Tacute coronary syndromechest paintroponin

Identifiers

PMID30773602
PMCPMC6717777

What OpenQuestion holds

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Registered trials

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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.