ArticleJournal of the American College of Cardiology2021
Troponin-Guided Coronary Computed Tomographic Angiography After Exclusion of Myocardial Infarction.
Article in Journal of the American College of Cardiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed, 50 citations in OpenAlex.
- Implementation of a high sensitivity cardiac troponin I assay and risk of myocardial infarction or death at five years: observational analysis of a stepped wedge, cluster randomised controlled trial.BMJ (Clinical research ed.) · 2023Trial
- Trial
- Presentation cardiac troponin and early computed tomography coronary angiography in patients with suspected acute coronary syndrome: a pre-specified secondary analysis of the RAPID-CTCA trial.European heart journal. Acute cardiovascular care · 2022Trial
- Article
- Coronary artery calcium score of zero does not rule out obstructive CAD in young adults.American heart journal plus : cardiology research and practice · 2026Article
- Cardiac troponin at the point of care in acute and chronic coronary syndromes.Diabetes, obesity & metabolism · 2025Review
- Multimodality Imaging in Eosinophilic Myocarditis: A Rare Cause of Heart Failure.Journal of cardiovascular development and disease · 2025Review
- Coronary computed tomography angiography in suspected acute coronary syndrome patients with intermediate high-sensitivity cardiac troponin I levels: a valuable diagnostic tool.Quantitative imaging in medicine and surgery · 2025Article
- Prevalence and Clinical Correlates of Radiologically Detected Coronary Artery Disease in Chronic Obstructive Pulmonary Disease: A Cross-Sectional Observational Study.American journal of respiratory and critical care medicine · 2025Observational
- Insulin-like growth factor binding protein-3 (IGFBP-3): a biomarker of coronary artery disease induced myocardial ischaemia.European heart journal open · 2025Article
- Coronary CT Angiography in the Emergency Department: State of the Art and Future Perspectives.Journal of cardiovascular development and disease · 2025Review
- Risk scores and coronary artery disease in patients with suspected acute coronary syndrome and intermediate cardiac troponin concentrations.Open heart · 2024Article
- From Atherosclerotic Plaque to Myocardial Infarction-The Leading Cause of Coronary Artery Occlusion.International journal of molecular sciences · 2024Review
- Review
- Clinical Biochemistry of Serum Troponin.Diagnostics (Basel, Switzerland) · 2024Review
- Prognostication in emergency room patients: comparing ultrasensitive and contemporary quantification of cardiac troponin levels below the 99th percentile.Frontiers in cardiovascular medicine · 2024Article
- Coronary Artery Disease: A Key Issue in Type 2 Myocardial Infarction: Systematic Review and Recent Findings.Journal of clinical medicine · 2023Review
- Coronary low-attenuation plaque and high-sensitivity cardiac troponin.Heart (British Cardiac Society) · 2023Article
- Computed tomographic angiography in coronary artery disease.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2023Article
- Computed tomography coronary angiography after excluding myocardial infarction: high-sensitivity troponin versus risk score-guided approach.World journal of emergency medicine · 2023Article
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16 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundPatients with suspected acute coronary syndrome in whom myocardial infarction has been excluded are at risk of future adverse cardiac events.
objectivesThis study evaluated the usefulness of high-sensitivity cardiac troponin I (hs-cTnI) to select patients for further investigation after myocardial infarction has been excluded.
methodsThis is a prospective cohort study of patients presenting to the emergency department with suspected acute coronary syndrome and hs-cTnI concentrations below the sex-specific 99th percentile. Patients were recruited in a 2:1 fashion, stratified by peak hs-cTnI concentration above and below the risk stratification threshold of 5 ng/L. All patients underwent coronary computed tomography angiography (CCTA) after hospital discharge.
resultsOverall, 250 patients were recruited (61.4 ± 12.2 years 31% women) in whom 62.4% (156 of 250 patients) had coronary artery disease (CAD). Patients with intermediate hs-cTnI concentrations (between 5 ng/L and the sex-specific 99th percentile) were more likely to have CAD than those with hs-cTnI concentrations <5 ng/L (71.9% [120 of 167 patients] vs 43.4% [36 of 83 patients]; odds ratio: 3.33; 95% CI: 1.92-5.78). Conversely, there was no association between anginal symptoms and CAD (63.2% [67 of 106 patients] vs 61.8% [89 of 144 patients]; odds ratio: 0.92; 95% CI: 0.48-1.76). Most patients with CAD did not have a previous diagnosis (53.2%; 83 of 156 patients) and were not on antiplatelet and statin therapies (63.5%; 99 of 156 patients) before they underwent CCTA.
conclusionsIn patients who had myocardial infarction excluded, CAD was 3× more likely in those with intermediate hs-cTnI concentrations compared with low hs-cTnI concentrations. In such patients, CCTA could help to identify those with occult CAD and to target preventative treatments, thereby improving clinical outcomes.
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