Evidence map›Paper›PMID 36017085›Full record

ArticleFrontiers in cardiovascular medicine2022

High-sensitivity troponin I with or without ultra-sensitive copeptin for the instant rule-out of acute myocardial infarction.

Fabrizio Ricci, Johannes T Neumann, Nicole Rübsamen, Nils A Sörensen, Francisco Ojeda, Ivana Cataldo, Tanja Zeller, Sarina Schäfer, Tau S Hartikainen, Maria Golato and 5 more

Open access · goldAbstract read
In one paragraph

Article in Frontiers in cardiovascular medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.8field-weighted citation impact, top 14% 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

8 citing papers in PubMed, 11 citations in OpenAlex.

  1. Trial
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  3. Observational
  4. Review
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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

15 authors at 7 institutions in 3 countries.

Fabrizio RicciDepartment of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University, Chieti-Pescara, Italy.
Johannes T NeumannDepartment of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany.
Nicole RübsamenDepartment of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany.
Nils A SörensenDepartment of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany.
Francisco OjedaDepartment of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany.
Ivana CataldoUnit of Clinical Pathology, SS. Annunziata University Hospital, Chieti, Italy.
Tanja ZellerDepartment of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany.
Sarina SchäferDepartment of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany.
Tau S HartikainenDepartment of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany.
Maria GolatoUnit of Clinical Pathology, SS. Annunziata University Hospital, Chieti, Italy.
Stefano PalermiPublic Health Department, University of Naples Federico II, Naples, Italy.
Marco ZimarinoDepartment of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University, Chieti-Pescara, Italy.
Stefan BlankenbergDepartment of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany.
Dirk WestermannDepartment of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany.
Raffaele De CaterinaCasa di Cura Villa Serena, Città Sant'Angelo, Pescara, Italy.
University Medical Center Hamburg-Eppendorf · DEGerman Centre for Cardiovascular Research · DELund University · SEUniversität Hamburg · DEUniversity of Chieti-Pescara · ITUniversity of Naples Federico II · ITUniversity of Pisa · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The instant, single-sampling rule-out of acute myocardial infarction (AMI) is still an unmet clinical need. We aimed at testing and comparing diagnostic performance and prognostic value of two different single-sampling biomarker strategies for the instant rule-out of AMI. Methods: From the Biomarkers in Acute Cardiac Care (BACC) cohort, we recruited consecutive patients with acute chest pain and suspected AMI presenting to the Emergency Department of the University Medical Center Hamburg-Eppendorf, Hamburg, Germany. We compared safety, effectiveness and 12-month incidence of the composite endpoint of all-cause death and myocardial infarction between (i) a single-sampling, dual-marker pathway combining high-sensitivity cardiac troponin I (hs-cTnI) and ultra-sensitive copeptin (us-Cop) at presentation (hs-cTnI ≤ 27 ng/L, us-Cop < 10 pmol/L and low-risk ECG) and (ii) a single-sampling pathway based on one-off hs-cTnI determination at presentation (hs-cTnI < 5 ng/L and low-risk ECG). As a comparator, we used the European Society of Cardiology (ESC) 0/1-h dual-sampling algorithm. Results: We enrolled 1,136 patients (male gender 65%) with median age of 64 years (interquartile range, 51-75). Overall, 228 (20%) patients received a final diagnosis of AMI. The two single-sampling instant rule-out pathways yielded similar negative predictive value (NPV): 97.4% (95%CI: 95.4-98.7) and 98.7% (95%CI: 96.9-99.6) for dual-marker and single hs-cTnI algorithms, respectively ( Conclusions: Instant rule-out pathways based on one-off determination of hs-cTnI alone or in combination with us-Cop are comparably safe as the ESC 0/1 h algorithm for the instant rule-out of AMI, yielding similar prognostic information. Instant rule-out strategies are safe alternatives to the ESC 0/1 h algorithm and allow the rapid and effective triage of suspected AMI in patients with low-risk ECG. However, adding copeptin to hs-cTn does not improve the safety of instant rule-out compared with the single rule-out hs-cTn at very low cut-off concentrations.

Indexed as

copeptincoronary artery diseaseemergency departmenthigh-sensitivity cardiac troponinmyocardial infarction

Identifiers

PMID36017085
PMCPMC9395923
OpenAlexW4292457788

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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.