Evidence map›Paper›PMID 38591997›Full record

ArticleEuropean heart journal. Cardiovascular Imaging2024

Combining anatomical and biochemical markers in the detection and risk stratification of coronary artery disease.

Miriam Albus, Tobias Zimmermann, Daniela Median, Klara Rumora, Ganna Isayeva, Melissa Amrein, Ibrahim Schaefer, Joan Walter, Evita Michel, Gabrielle Huré and 6 more

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European heart journal. Cardiovascular Imaging, 2024. 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
–field-weighted citation impact
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. 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

16 authors.

Miriam AlbusCardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031, Basel, Switzerland.
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
Daniela MedianCardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031, Basel, Switzerland.
Klara RumoraCardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031, Basel, Switzerland.
Ganna IsayevaCardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031, Basel, Switzerland.
Melissa AmreinCardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031, Basel, Switzerland.
Ibrahim SchaeferCardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031, Basel, Switzerland.
Joan WalterCardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031, Basel, Switzerland.
Evita MichelCardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031, Basel, Switzerland.
Gabrielle HuréCardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031, Basel, Switzerland.
Ivo StrebelCardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031, Basel, Switzerland.
Federico CaobelliDepartment of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.
Philip HaafCardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031, Basel, Switzerland.ORCID 0000-0002-5657-6637
Simon M FreyCardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031, Basel, 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
Michael J ZellwegerCardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031, Basel, Switzerland.ORCID 0000-0001-7027-5622

Funding

AbbottAstra ZenecaEuropean Union, the University of BaselNovartisRocheSwiss Heart FoundationThe University Hospital Basel
6 · The paper itself

Abstract

aimsWe aimed to test the hypothesis if combining coronary artery calcium score (Ca-score) as a quantitative anatomical marker of coronary atherosclerosis with high-sensitivity cardiac troponin as a quantitative biochemical marker of myocardial injury provided incremental value in the detection of functionally relevant coronary artery disease (fCAD) and risk stratification. METHODS AND

resultsConsecutive patients undergoing myocardial perfusion single-photon emission computed tomography (MPS) without prior CAD were enrolled. The diagnosis of fCAD was based on the presence of ischaemia on MPS and coronary angiography; fCAD was centrally adjudicated in the diagnostic and prognostic domain. Diagnostic accuracy was evaluated using the area under the receiver-operating characteristic curve (AUC). The composite of cardiovascular death and non-fatal acute myocardial infarction (AMI) within 730 days was the primary prognostic endpoint. Among 1715 patients eligible for the diagnostic analysis, 399 patients had fCAD. The combination of Ca-score and high-sensitivity cardiac troponin T (hs-cTnT) had good diagnostic accuracy for the diagnosis of fCAD (AUC 0.79, 95% confidence interval (CI) 0.77-0.81), but no incremental value compared with the Ca-score alone (AUC 0.79, 95% CI 0.77-0.81, P = 0.965). Similar results were observed using high-sensitivity cardiac troponin I (AUC 0.80, 95% CI 0.77-0.82) instead of hs-cTnT. Among 1709 patients (99.7%) with available follow-up, 59 patients (3.5%) suffered the composite primary prognostic endpoint (non-fatal AMI, n = 34; CV death, n = 28). Both Ca-score and hs-cTnT had independent prognostic value. Increased risk was restricted to patients with elevation in both markers.

conclusionThe combination of the Ca-score with hs-cTnT increases the prognostic accuracy for future events but does not provide incremental value vs. the Ca-score alone for the diagnosis of fCAD. STUDY REGISTRATION: Clinical trial registration: NCT00470587.

Indexed as

BiomarkersCoronary AngiographyCoronary Artery DiseaseTomography, Emission-Computed, Single-PhotonTroponin TAgedCohort StudiesFemaleHumansMaleMiddle AgedMyocardial Perfusion ImagingPrognosisProspective StudiesRisk AssessmentBiomarkersTroponin TAgatston scorecalcium scorecoronary artery diseasehigh-sensitivity cardiac troponinmyocardial ischaemiamyocardial perfusion SPECTprognosis

Identifiers

PMID38591997
PMCPMC11346366

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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.