Evidence map›Paper›PMID 36917461›Full record

ArticleEuropean heart journal. Acute cardiovascular care2023

Association of accompanying dyspnoea with diagnosis and outcome of patients presenting with acute chest discomfort.

Jasper Boeddinghaus, Thomas Nestelberger, Luca Koechlin, Pedro Lopez-Ayala, Desiree Wussler, Maximilian Mais, Luca Zwimpfer, Tobias Zimmermann, Karin Wildi, Maria Rubini Giménez and 11 more

Registry-linked trialOpen access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European heart journal. Acute cardiovascular care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00470587 (Advantageous Predictors of Acute Coronary Syndromes Evaluation), which is not on this 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
1.1field-weighted citation impact, top 21% 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.

NCT00470587 completednot on this map

Advantageous Predictors of Acute Coronary Syndromes Evaluation (APACE) Study

TypeobservationalSponsorUniversity Hospital, Basel, SwitzerlandRan2006 to 2025Enrolled10,000ConditionsMyocardial Infarction, Angina, Unstable
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  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

21 authors at 7 institutions in 6 countries.

Jasper BoeddinghausCardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031 Basel, Switzerland.ORCID 0000-0003-4404-4956
Thomas NestelbergerCardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031 Basel, Switzerland.ORCID 0000-0003-2173-5738
Luca KoechlinCardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031 Basel, Switzerland.ORCID 0000-0002-2929-8600
Pedro Lopez-AyalaCardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031 Basel, Switzerland.ORCID 0000-0002-7787-0640
Desiree WusslerCardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031 Basel, Switzerland.ORCID 0000-0002-1793-5297
Maximilian MaisCardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031 Basel, Switzerland.
Luca ZwimpferCardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031 Basel, Switzerland.ORCID 0000-0003-3269-5786
Tobias ZimmermannCardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031 Basel, Switzerland.ORCID 0000-0002-6862-5205
Karin WildiCardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031 Basel, Switzerland.
Maria Rubini GiménezCardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031 Basel, Switzerland.ORCID 0000-0003-2384-8250
Ivo StrebelCardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031 Basel, Switzerland.
Òscar MiróGREAT network, Rome, Italy.
F Javier Martin-SanchezGREAT network, Rome, Italy.
Jiri ParenicaDepartment of Cardiology, University Hospital Brno, Brno, Czech Republic and Medical Faculty, Masaryk University, Brno, Czech Republic.
Dagmar I KellerEmergency Department, University Hospital Zurich, Zurich, Switzerland.
Danielle M GualandroCardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031 Basel, Switzerland.
Christian H NickelEmergency Department, University Hospital Basel, University of Basel, Switzerland.
Roland BingisserEmergency Department, University Hospital Basel, University of Basel, Switzerland.
Michael ChristEmergency Department, Kantonsspital Luzern, Switzerland.
Christian MuellerCardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031 Basel, Switzerland.ORCID 0000-0002-1120-6405
APACE investigators
University of Basel · CHHospital Clínic de Barcelona · ESHospital Clínico San Carlos · ESLuzerner Kantonsspital · CHMasaryk University · CZThe University of Queensland · AUUniversity Hospital of Zurich · CH

Funding

Swiss National Science Foundation
6 · The paper itself

Abstract

aimsThe presence of accompanying dyspnoea is routinely assessed and common in patients presenting with acute chest pain/discomfort to the emergency department (ED). We aimed to assess the association of accompanying dyspnoea with differential diagnoses, diagnostic work-up, and outcome. METHODS AND

resultsWe enrolled patients presenting to the ED with chest pain/discomfort. Final diagnoses were adjudicated by independent cardiologists using all information including cardiac imaging. The primary diagnostic endpoint was the final diagnosis. The secondary diagnostic endpoint was the performance of high-sensitivity cardiac troponin (hs-cTn) and the European Society of Cardiology (ESC) 0/1h-algorithms for the diagnosis of myocardial infarction (MI). The prognostic endpoints were cardiovascular and all-cause mortality at two years. Among 6045 patients, 2892/6045 (48%) had accompanying dyspnoea. The prevalence of acute coronary syndrome (ACS) in patients with vs. without dyspnoea was comparable (MI 22.4% vs. 21.9%, P = 0.60, unstable angina 8.7% vs. 7.9%, P = 0.29). In contrast, patients with dyspnoea more often had cardiac, non-coronary disease (15.3% vs. 10.2%, P < 0.001). Diagnostic accuracy of hs-cTnT/I concentrations was not affected by the presence of dyspnoea (area under the curve 0.89-0.91 in both groups), and the safety of the ESC 0/1h-algorithms was maintained with negative predictive values >99.4%. Accompanying dyspnoea was an independent predictor for cardiovascular and all-cause death at two years [hazard ratio 1.813 (95% confidence intervals, 1.453-2.261, P < 0.01)].

conclusionAccompanying dyspnoea was not associated with a higher prevalence of ACS but with cardiac, non-coronary disease. While the safety of the diagnostic work-up was not affected, accompanying dyspnoea was an independent predictor for cardiovascular and all-cause death. CLINICAL

trial registrationhttps://clinicaltrials.gov/ct2/show/NCT00470587, number NCT00470587.

Indexed as

Acute Coronary SyndromeMyocardial InfarctionBiomarkersChest PainDyspneaHumansPredictive Value of TestsPrognosisTroponin TBiomarkersTroponin T0/1h-algorithmDiagnosis of MIDyspnoeaHigh-sensitivity cardiac troponin

Identifiers

PMID36917461
PMCPMC10243981
OpenAlexW4324129256

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.