Evidence map›Paper›PMID 33855162›Full record

ArticleInternational journal of cardiology. Heart & vasculature2021

Comparing conventional and high sensitivity troponin T measurements in identifying adverse cardiac events in patients admitted to an Asian emergency department chest pain observation unit.

Ziwei Lin, Swee Han Lim, Qai Ven Yap, Carol Hui Chen Tan, Yiong Huak Chan, Hung Chew Wong, E Shyong Tai, Arthur Mark Richards, Terrance Siang Jin Chua

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of cardiology. Heart & vasculature, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.8field-weighted citation impact, top 27% of its field
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

1 citing paper in PubMed, 7 citations in OpenAlex.

  1. 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

9 authors at 4 institutions in 2 countries.

Ziwei LinEmergency Medicine Department, National University Hospital, National University Health System, Singapore.
Swee Han LimDepartment of Emergency Medicine, Singapore General Hospital, Singapore.
Qai Ven YapBiostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore.
Carol Hui Chen TanDepartment of Clinical Pathology, Clinical Biochemistry, Singapore General Hospital, Singapore.
Yiong Huak ChanBiostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore.
Hung Chew WongBiostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore.
E Shyong TaiDivision of Endocrinology, National University Hospital, National University Health System, Singapore.
Arthur Mark RichardsCardiovascular Research Institute, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Terrance Siang Jin ChuaDepartment of Cardiology, National Heart Centre, Singapore.
National University of Singapore · SGNational University Hospital · SGSingapore General Hospital · SGNational Heart Centre Singapore · SG

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHigh sensitive cardiac troponin assays can be used for prediction of major adverse cardiac events (MACE) in patients with chest pain.

methodsWe included patients with symptoms suggestive of acute coronary syndrome in the emergency department observation unit. We compared the accuracy of conventional troponin T (cTnT) with high sensitive troponin T (hsTnT) at various ranges, as well as the utility of hsTnT and cTnT in prediction of 30-day and 1-year MACE.

results1023 patients were included (68.1% male, median age 56 years). There were 2712 hsTnT and cTnT values compared. hsTnT had a higher AUC than cTnT for 30-day and 1-year MACE. The optimal cut-off of 0-hour hsTnT for 30-day (PPV 34%, NPV 96.6%) and 1-year MACE (PPV 40.2%, NPV 94.2%) was 16 ng/L.For 844 patients who had values for both 0 and 2 h hsTnT, we proposed a rule-out cut-off of 0 and 2 h hsTnT < 16 ng/L (NPV 97.0%, 95%CI 95.5-98.1%) and a rule-in cut-off of 0 and 2 h hsTnT ≥ 26 ng/L (PPV 58.8%, 95%CI 40.7%-75.4%) for 30-day MACE. Negative 0-2 h delta-hsTnT had poor predictive discriminant capabilities on 30-day (PPV 8.2%) and 1-year MACE (PPV 12.3%).

conclusionThe cut off values of hsTnT used in the 0 and 2-hour algorithm to rule-out (16 ng/L) and rule-in MACE (26 ng/L) are in the range that previous cTnT assays are unable to measure accurately. Risk scores can be used to further improve NPV of the rule-out group. A fall in hsTnT level acutely is not predictive of MACE.

Indexed as

Acute coronary syndromeBiomarkersChest painMajor adverse cardiac eventsMyocardial infarctionTroponin

Identifiers

PMID33855162
PMCPMC8027767
OpenAlexW3144913424

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

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.