Evidence map›Paper›PMID 38992971›Full record

ArticleESC heart failure2024

Interpretation of elevated baseline concentrations and serial changes of high-sensitivity cardiac troponin T in confirmed muscular dystrophies.

Mustafa Yildirim, Christoph Reich, Christian Salbach, Regina Pribe-Wolferts, Barbara Ruth Milles, Tobias Täger, Matthias Mueller-Hennessen, Markus Weiler, Benjamin Meder, Norbert Frey and 1 more

Abstract read
In one paragraph

Article in ESC heart failure, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

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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

3 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Mustafa YildirimDepartment of Internal Medicine III, Cardiology, University Hospital of Heidelberg, Heidelberg, Germany.ORCID 0000-0001-6783-143X
Christoph ReichDepartment of Internal Medicine III, Cardiology, University Hospital of Heidelberg, Heidelberg, Germany.
Christian SalbachDepartment of Internal Medicine III, Cardiology, University Hospital of Heidelberg, Heidelberg, Germany.
Regina Pribe-WolfertsDepartment of Internal Medicine III, Cardiology, University Hospital of Heidelberg, Heidelberg, Germany.
Barbara Ruth MillesDepartment of Internal Medicine III, Cardiology, University Hospital of Heidelberg, Heidelberg, Germany.
Tobias TägerDepartment of Internal Medicine III, Cardiology, University Hospital of Heidelberg, Heidelberg, Germany.
Matthias Mueller-HennessenDepartment of Internal Medicine III, Cardiology, University Hospital of Heidelberg, Heidelberg, Germany.
Markus WeilerDepartment of Neurology, University Hospital of Heidelberg, Heidelberg, Germany.
Benjamin MederDepartment of Internal Medicine III, Cardiology, University Hospital of Heidelberg, Heidelberg, Germany.
Norbert FreyDepartment of Internal Medicine III, Cardiology, University Hospital of Heidelberg, Heidelberg, Germany.
Evangelos GiannitsisDepartment of Internal Medicine III, Cardiology, University Hospital of Heidelberg, Heidelberg, Germany.

Funding

Roche Diagnostics
6 · The paper itself

Abstract

aimsConcentrations of high-sensitivity cardiac troponin T (hs-cTnT) are frequently elevated in stable patients with confirmed muscle dystrophies. However, sparse information is available on the interpretation of serial concentration changes.

methodsHs-cTnT was collected in 35 stable outpatients with confirmed skeletal muscle dystrophies at 0 and 1 h and after 6-12 months during scheduled outpatient visits. We simulated the effectiveness of the European Society of Cardiology (ESC) 0/1 h algorithm and assessed biological variation at 6-12 months using two established methods: reference change value (RCV) and minimal important difference (MID).

resultsMedian baseline hs-cTnT concentrations were 34.4 ng/L [inter-quartile range (IQR): 17.5-46.2], and values > 99th percentile upper limit of normal were present in 34 of 35 patients. All patients were stable without cardiovascular adverse events during a follow-up of 6.6 months (IQR: 6-7). Median concentration change was 1.9 ng/L (IQR: 0.7-3.2) and 0.8 ng/L (IQR: 0-7.0) at 60 min and 6-9 months, respectively. Applying the criteria of the ESC 0/1 h algorithm for triage of suspected acute coronary syndrome (ACS) showed poor overall effectiveness of baseline hs-cTnT values. No patient would qualify for rule-out based on hs-cTnT less than the limit of detection, whereas five cases would qualify for rule-in based on hs-cTnT ≥ 52 ng/L. Biological variabilities at 6-12 months per MID and RCV were 1.2 ng/L [95% confidence interval (CI): 0.7-2.1] and 28.6% (95% CI: 27.9-29.6), respectively. A total of 8 (22.9%) and 25 (71.4%) cases exceeded the biological variation range, suggesting some additional myocardial damage.

conclusionsThe high prevalence of elevated hs-cTnT could negatively impact the effectiveness of rule-out and rule-in strategies based on a single hs-cTnT value. Knowledge of the physiological and biological variation of hs-cTnT after 6-12 months is helpful to detect the progression of cardiac involvement or to search for cardiac complications including but not limited to arrhythmias that may trigger acute or chronic myocardial damage.

Indexed as

BiomarkersMuscular DystrophiesTroponin TAdultAlgorithmsFemaleFollow-Up StudiesHumansMaleMiddle AgedBiomarkersTroponin Tbiological variationESC 0/1 h algorithmhigh‐sensitivity cardiac troponinskeletal muscle dystrophies

Identifiers

PMID38992971
PMCPMC11631257

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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.