Evidence map›Paper›PMID 37670005›Full record

ArticleScientific reports2023

Combining glucose and high-sensitivity cardiac troponin in the early diagnosis of acute myocardial infarction.

Ana Yufera-Sanchez, Pedro Lopez-Ayala, Thomas Nestelberger, Karin Wildi, Jasper Boeddinghaus, Luca Koechlin, Maria Rubini Gimenez, Hüseyin Sakiz, Paolo Bima, Oscar Miro and 9 more

Registry-linked trialOpen access · goldAbstract read
In one paragraph

Article in Scientific reports, 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 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 42% 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

1 citing paper in PubMed, 1 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

19 authors at 9 institutions in 6 countries.

Ana Yufera-Sanchez *Department of Cardiology, University Heart Center Basel, and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel, Switzerland.
Pedro Lopez-Ayala *Department of Cardiology, University Heart Center Basel, and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel, Switzerland.
Thomas NestelbergerDepartment of Cardiology, University Heart Center Basel, and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel, Switzerland.
Karin WildiDepartment of Cardiology, University Heart Center Basel, and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel, Switzerland.
Jasper BoeddinghausDepartment of Cardiology, University Heart Center Basel, and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel, Switzerland.
Luca KoechlinDepartment of Cardiology, University Heart Center Basel, and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel, Switzerland.
Maria Rubini GimenezDepartment of Cardiology, University Heart Center Basel, and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel, Switzerland.
Hüseyin SakizDepartment of Cardiology, University Heart Center Basel, and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel, Switzerland.
Paolo BimaDepartment of Cardiology, University Heart Center Basel, and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel, Switzerland.
Oscar MiroGREAT Network, Basel, Switzerland.
F Javier Martín-SánchezGREAT Network, Basel, Switzerland.
Michael ChristDepartment of Emergency Medicine, Luzerner Kantonsspital, Luzern, Switzerland.
Dagmar I KellerEmergency Department, University Hospital Zurich, Zurich, Switzerland.
Danielle M GualandroDepartment of Cardiology, University Heart Center Basel, and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel, Switzerland.
Damian Kawecki2nd Department of Cardiology, School of Medicine in Zabrze, Medical University of Sielsia, Katowice, Poland.
Katharina RentschLaboratory Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.
Andreas BuserBlood Transfusion Centre, Swiss Red Cross, Basel, Switzerland.
Christian MuellerDepartment of Cardiology, University Heart Center Basel, and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel, Switzerland. christian.mueller@usb.ch.
APACE Investigators
University of Basel · CHUniversity Hospital of Basel · CHHospital Clínic de Barcelona · ESHospital Clínico San Carlos · ESLuzerner Kantonsspital · CHMedical University of Silesia · PLSwiss Red Cross · CHUniversity Hospital of Zurich · CHUniversity of Turin · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Glucose is a universally available inexpensive biomarker, which is increased as part of the physiological stress response to acute myocardial infarction (AMI) and may therefore help in its early diagnosis. To test this hypothesis, glucose, high-sensitivity cardiac troponin (hs-cTn) T, and hs-cTnI were measured in consecutive patients presenting with acute chest discomfort to the emergency department (ED) and enrolled in a large international diagnostic study (NCT00470587). Two independent cardiologists centrally adjudicated the final diagnosis using all clinical data, including serial hs-cTnT measurements, cardiac imaging and clinical follow-up. The primary diagnostic endpoint was index non-ST-segment elevation MI (NSTEMI). Prognostic endpoints were all-cause death, and cardiovascular (CV) death or future AMI, all within 730-days. Among 5639 eligible patients, NSTEMI was the adjudicated final diagnosis in 1051 (18.6%) patients. Diagnostic accuracy quantified using the area under the receiver-operating characteristics curve (AUC) for the combination of glucose with hs-cTnT and glucose with hs-cTnI was very high, but not higher versus that of hs-cTn alone (glucose/hs-cTnT 0.930 [95% CI 0.922-0.937] versus hs-cTnT 0.929 [95% CI 0.922-0.937]; glucose/hs-cTnI 0.944 [95% CI 0.937-0.951] versus hs-cTnI 0.944 [95% CI 0.937-0.951]). In early-presenters, a dual-marker strategy (glucose < 7 mmol/L and hs-cTnT < 5/hs-cTnI < 4 ng/L) provided very high and comparable sensitivity to slightly lower hs-cTn concentrations (cTnT/I < 4/3 ng/L) alone, and possibly even higher efficacy. Glucose was an independent predictor of 730-days endpoints. Our results showed that a dual marker strategy of glucose and hs-cTn did not increase the diagnostic accuracy when used continuously. However, a cutoff approach combining glucose and hs-cTn may provide diagnostic utility for patients presenting ≤ 3 h after onset of symptoms, also providing important prognostic information.

Indexed as

Myocardial InfarctionNon-ST Elevated Myocardial InfarctionAnthraquinonesEarly DiagnosisGlucoseHumansPyrazolesTroponinAnthraquinonesGlucosePyrazolesteloxantroneTroponin

Identifiers

PMID37670005
PMCPMC10480296
OpenAlexW4386442641

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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.