Evidence map›Paper›PMID 38250703›Full record

ArticleGlobal heart2024

Unstable Angina: Risk Stratification for Significant Coronary Artery Disease in The Era of High-Sensitivity Cardiac Troponin.

Luis Paiva, Maria João Vieira, Rui Baptista, Maria João Ferreira, Lino Gonçalves

Open access · goldAbstract read
In one paragraph

Article in Global heart, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.6field-weighted citation impact, top 17% 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

4 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. Incidence and 1-Year Prognostic of Unstable Angina After High-Sensitivity Troponin Assessment.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2025
    Observational
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

5 authors at 1 institution in 1 country.

Luis PaivaFaculdade de Medicina, Universidade de Coimbra, Portugal.ORCID 0000-0002-9689-8155
Maria João VieiraCoimbra Institute for Clinical and Biomedical Research (iCBR), Universidade de Coimbra, Portugal.ORCID 0000-0001-6146-9652
Rui BaptistaFaculdade de Medicina, Universidade de Coimbra, Portugal.ORCID 0000-0002-7411-7039
Maria João FerreiraCoimbra Institute for Clinical and Biomedical Research (iCBR), Universidade de Coimbra, Portugal.ORCID 0000-0001-8952-8618
Lino GonçalvesFaculdade de Medicina, Universidade de Coimbra, Portugal.ORCID 0000-0001-9255-3064
Hospitais da Universidade de Coimbra · PT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: High-sensitivity troponin (hsTn) has a very high diagnostic accuracy for myocardial infarction (MI), and patients who were formerly diagnosed with unstable angina (UA) are being reclassified as having NSTEMI in the era of hsTn. This paradigm shift has changed the clinical features of UA, which remain poorly characterized, specifically the occurrence of obstructive coronary artery disease (CAD) and the need for myocardial revascularization. The main purpose of this study was to clinically characterize contemporary UA patients, assess predictors of obstructive CAD, and develop a risk model to predict significant CAD in this population. Methods: We conducted a retrospective cohort study of 742 patients admitted to the hospital with UA. All patients underwent coronary angiography. The endpoint of the study was the presence of obstructive CAD on angiography. The cohort was divided into two groups: patients with significant coronary artery disease (CAD Results: Obstructive CAD was observed on angiography in 53% of the patients. Age, dyslipidemia, troponin level, male sex, ST-segment depression, and wall motion abnormalities on echocardiography were independent predictors of obstructive CAD. hsTn levels (undetectable vs. nonsignificant detection) had a negative predictive value of 81% to exclude obstructive CAD. We developed a prediction model with obstructive CAD as the outcome (AUC: 0.60). Conclusions: In a contemporary UA cohort, approximately 50% of the patients did not have obstructive CAD on angiography. Commonly available cardiac tests at hospital admission show limited discrimination power in identifying patients at risk of obstructive CAD. A revised diagnostic and etiology algorithm for patients with UA is warranted.

Indexed as

Coronary Artery DiseaseAngina, UnstableHumansMaleRetrospective StudiesRisk AssessmentTroponinTroponinhigh-sensitivity troponinnon-ST-segment elevation acute coronary syndromeobstructive coronary artery diseaserisk assessmentunstable angina

Identifiers

PMID38250703
PMCPMC10798171
OpenAlexW4391027056

What OpenQuestion holds

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Read underepoch 390

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.