Diagnostic and prognostic value of high-sensitivity cardiac troponin T in patients with syncope
Objective: We examined the diagnostic and predictive value of high-sensitivity cardiac troponin T (cTnThs) in patients with syncope. Methods: We performed an analysis of consecutive patients with syncope presenting to the emergency department. The primary end point was the accuracy to diagnose a car...
Gespeichert in:
| Hauptverfasser: | , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
February 2015
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| In: |
The American journal of medicine
Year: 2015, Jahrgang: 128, Heft: 2, Pages: 161-170.e1 |
| ISSN: | 1555-7162 |
| DOI: | 10.1016/j.amjmed.2014.09.021 |
| Online-Zugang: | Verlag, Volltext: http://dx.doi.org/10.1016/j.amjmed.2014.09.021 Verlag, Volltext: http://www.sciencedirect.com/science/article/pii/S0002934314008961 
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| Verfasserangaben: | Michael Christ, MD, Felicitas Geier, MSc, Steffen Popp, MD, Katrin Singler, MD, Alexander Smolarsky, MD, Thomas Bertsch, MD, Christian Müller, MD, Yvonne Greve, MD |
MARC
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| 245 | 1 | 0 | |a Diagnostic and prognostic value of high-sensitivity cardiac troponin T in patients with syncope |c Michael Christ, MD, Felicitas Geier, MSc, Steffen Popp, MD, Katrin Singler, MD, Alexander Smolarsky, MD, Thomas Bertsch, MD, Christian Müller, MD, Yvonne Greve, MD |
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| 520 | |a Objective: We examined the diagnostic and predictive value of high-sensitivity cardiac troponin T (cTnThs) in patients with syncope. Methods: We performed an analysis of consecutive patients with syncope presenting to the emergency department. The primary end point was the accuracy to diagnose a cardiac syncope. In addition, the study explored the prognostic relevance of cTnThs in patients with cardiac and noncardiac syncope. Results: A total of 360 patients were enrolled (median age, 70.5 years; male, 55.8%; 23.9% aged >80 years). Cardiac syncope was present in 22% of patients, reflex syncope was present in 40% of patients, syncope due to orthostatic hypotension was present in 20% of patients, and unexplained syncope was present in 17.5% of patients. A total of 148 patients (41%) had cTnThs levels above the 99% confidence interval (CI) (cutoff point). The diagnostic accuracy for cTnThs levels to determine the diagnosis of cardiac syncope was quantified by the area under the curve (0.77; CI, 0.72-0.83; P < .001). A comparable area under the curve (0.78; CI, 0.73-0.83; P < .001) was obtained for the predictive value of cTnThs levels within 30 days: Patients with increased cTnThs levels had a 52% likelihood for adverse events, patients with cTnThs levels below the cutoff point had a low risk (negative predictive value, 83.5%). Increased cTnThs levels indicate adverse prognosis in patients with noncardiac causes of syncope, but not in patients with cardiac syncope being a risk factor for adverse outcome by itself. Conclusions: Patients with syncope presenting to the emergency department have a high proportion of life-threatening conditions. cTnThs levels show a limited diagnostic and predictive accuracy for the identification of patients with syncope at high risk. | ||
| 650 | 4 | |a Cardiac troponin | |
| 650 | 4 | |a Emergency service | |
| 650 | 4 | |a Healthcare | |
| 650 | 4 | |a Hospital | |
| 650 | 4 | |a Quality Indicators | |
| 650 | 4 | |a Quality of Healthcare | |
| 650 | 4 | |a Syncope | |
| 700 | 1 | |a Bertsch, Thomas |e VerfasserIn |0 (DE-588)105441193X |0 (DE-627)791504999 |0 (DE-576)410254835 |4 aut | |
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