Impact of age on the performance of the ESC 0/1h-algorithms for early diagnosis of myocardial infarction

European Heart Journal
Jasper BoeddinghausAPACE, BACC, and TRAPID-AMI Investigators

Abstract

We aimed to evaluate the impact of age on the performance of the European Society of Cardiology (ESC) 0/1h-algorithms and to derive and externally validate alternative cut-offs specific to older patients. We prospectively enrolled patients presenting to the emergency department (ED) with symptoms suggestive of acute myocardial infarction in three large diagnostic studies. Final diagnoses were adjudicated by two independent cardiologists. High-sensitivity cardiac troponin (hs-cTn) T and I concentrations were measured at presentation and after 1 h. Patients were stratified according to age [<55 years (young), ≥55 to <70 years (middle-age), ≥70 years (old)]. Rule-out safety of the ESC hs-cTnT 0/1h-algorithm was very high in all age-strata: sensitivity 100% [95% confidence interval (95% CI) 94.9-100] in young, 99.3% (95% CI 96.0-99.9) in middle-age, and 99.3% (95% CI 97.5-99.8) in old patients. Accuracy of rule-in decreased with age: specificity 97.0% (95% CI 95.8-97.9) in young, 96.1% (95% CI 94.5-97.2) in middle-age, and 92.7% (95% CI 90.7-94.3) in older patients. Triage efficacy decreased with increasing age (young 93%, middle-age 80%, old 55%, P < 0.001). Similar results were found for the ESC hs-cTnT 0/1h-algorithm. Alternativ...Continue Reading

Associated Clinical Trials

Feb 4, 2015·PD Dr. Dirk Westermann

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Citations

Jun 5, 2019·Biomarkers : Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals·Beatrice von JeinsenTill Keller
Apr 17, 2019·Clinical Chemistry·Jasper BoeddinghausUNKNOWN APACE investigators
Oct 2, 2019·Clinical Chemistry·Jasper BoeddinghausUNKNOWN APACE investigators
Jan 7, 2020·European Heart Journal·Adrian P BanningThomas F Lüscher
May 31, 2019·Heart·Thomas NestelbergerUNKNOWN APACE, ADAPT and TRAPID-AMI Investigators
Aug 12, 2020·Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation·G W A AartsP Damman
Aug 30, 2020·European Heart Journal·Jean-Philippe ColletUNKNOWN ESC Scientific Document Group
Feb 6, 2020·BioMed Research International·Xi-Ying WangJian Yang
Mar 30, 2019·Medizinische Klinik, Intensivmedizin und Notfallmedizin·M VafaieE Giannitsis
Mar 4, 2021·European Heart Journal. Acute Cardiovascular Care·Christian MuellerUNKNOWN ESC Study Group on Biomarkers in Cardiology of the Acute Cardiovascular Care Association
Feb 27, 2021·Clinical Biochemistry·Karin WildiChristian Mueller
Jul 2, 2021·European Heart Journal. Acute Cardiovascular Care·Thomas NestelbergerUNKNOWN APACE investigators
Aug 6, 2021·European Heart Journal. Acute Cardiovascular Care·Paul Michael HallerDirk Westermann
Aug 24, 2021·European Heart Journal. Acute Cardiovascular Care·Camilla Fuchs AndersenBo Løfgren
Sep 26, 2020·Journal of the American College of Cardiology·Daniel E FormanUNKNOWN Geriatric Cardiology Section Leadership Council
Nov 19, 2021·European Heart Journal·UNKNOWN Task Force for the management of COVID-19 of the European Society of Cardiology
Dec 6, 2021·Cardiovascular Research·UNKNOWN Task Force for the management of COVID-19 of the European Society of Cardiology

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