Abstract:
:Background: Patients with chest pain are risk-stratified using serial high-sensitivity troponin (T) assays (hsTnT). Those with change in (Δ)hsTnT <20% are often categorised as low-risk and are less likely to be managed as acute coronary syndromes (ACS). We sought to characterise such a population of 'low-risk' chest pain presenters.Methods: We performed a retrospective cohort analysis of sequential patients admitted to our centre over a 1-year period with chest pain, absence of ST-elevation, with elevated hsTnT concentrations, and compared demographic, clinical and outcome data according to ΔhsTnT.Results: Three hundred and eleven patients were subdivided by ΔhsTnT [<20% (n = 80), 20-100% (n = 78), >100% (n = 153)]. Baseline demographic data were well-matched across the three subgroups; atrial fibrillation was more common in the two lower magnitude ΔhsTnT groups. Obstructive coronary artery disease (CAD) - while less common in those with ΔhsTnT <20% (66.2%) compared to the 20-100% (73.1%) and >100% (75.9%) groups (p = 0.03) - remained high in this lower risk group, and indeed revascularisation occurred in >60% of patients, equally frequently in all three groups. Using absolute ΔhsTnT ≥9ng/L within the ΔhsTnT <20% group provided incremental value in ruling in ACS, with a positive predictive value of 74.1%. ΔhsTnT was a univariate but not a multivariate predictor of obstructive CAD.Conclusions: Obstructive CAD and need for revascularisation are frequent in chest pain presenters with ΔhsTnT <20%. The increasing focus on hsTnT algorithms to exclude ACS and promote early discharge without adequate clinical risk stratification modelling risks misdiagnosis of patients presenting with acute myocardial ischaemia with a low-level hsTnT rise.
journal_name
Acta Cardioljournal_title
Acta cardiologicaauthors
Weir RAP,Osmanska J,Docherty KF,Petrie CJdoi
10.1080/00015385.2018.1561598subject
Has Abstractpub_date
2020-04-01 00:00:00pages
149-155issue
2eissn
0001-5385issn
1784-973Xjournal_volume
75pub_type
杂志文章abstract:AIMS:We retrospectively followed 250 patients who started dialysis between 2005 and 2009 to clarify the prevalence, the prognosis and the prescribed heart failure treatment of systolic heart failure patients on dialysis. METHODS AND RESULTS:This cohort was divided according to left ventricular ejection fraction (LVEF)...
journal_title:Acta cardiologica
pub_type: 杂志文章
doi:10.1080/ac.68.1.2959632
更新日期:2013-02-01 00:00:00
abstract::Epidemiological information on the prevalence, incidence and natural history of intermittent claudication and peripheral vascular disease is limited, partially by the limitation of techniques of their study. The available data from the literature are review and supplemented by results from an on-going survey the ankle...
journal_title:Acta cardiologica
pub_type: 杂志文章
doi:
更新日期:1979-01-01 00:00:00
abstract:UNLABELLED:The aim of study was to determine the significance of the best echocardiographic parameters for assessing the severity of mitral regurgitation (MR). METHODS:The study population consisted of 107 patients, mean age 52 +/- 7 y with chronic isolated non-ischaemic MR. Quantification of the MR was performed usin...
journal_title:Acta cardiologica
pub_type: 杂志文章
doi:10.2143/AC.64.2.2036136
更新日期:2009-04-01 00:00:00
abstract::Between January 1970 and August 1974, eleven postinfarction patients underwent left ventricular aneurysmectomy for refractory tachyarrhythmias. Ten suffered from ventricular tachycardias and one from supraventricular tachycardia. All had localized aneurysms and normal contractions of the surrounding myocardium on angi...
journal_title:Acta cardiologica
pub_type: 杂志文章
doi:
更新日期:1976-01-01 00:00:00
abstract::Introduction Strength exercises influence the cardiovascular system by promoting autonomic adjustments induced by the increased metabolic demand and consequent increase in local blood flow. However, it is unclear whether there are differences between upper and lower limbs. We aimedto evaluate recovery of cardiac auton...
journal_title:Acta cardiologica
pub_type: 杂志文章
doi:10.1080/00015385.2017.1335454
更新日期:2017-08-01 00:00:00
abstract::In order to prepare Belgian participation in the International Study "Monitoring of trends and determinants in cardiovascular disease (MONICA)", a pilot project for registration of acute myocardial infarctions was organized in the Flemish city of Ghent and the Walloon city of Charleroi. Thanks to the collaboration of ...
journal_title:Acta cardiologica
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract:OBJECTIVE:Cigarette smoking increases the synthesis of angiotensin-1 converting enzyme (ACE) and induces oxidative modifications of the apolipoprotein E (apo E).Thus we explored the gene-environment interactions between APOE gene epsilon and ACE gene insertion/deletion polymorphisms and cigarette smoking in coronary ar...
journal_title:Acta cardiologica
pub_type: 杂志文章
doi:10.2143/AC.63.6.2033392
更新日期:2008-12-01 00:00:00
abstract:OBJECTIVE:dobutamine stress echocardiography (DSE) in patients with ischaemic cardiomyopathy. We explored the accuracy of resting echocardiographic and tissue Doppler parameters to predict a positive response by low-dose METHODS AND RESULTS:We enrolled 100 consecutive patients with prior myocardial infarction, and a l...
journal_title:Acta cardiologica
pub_type: 杂志文章
doi:10.1080/ac.67.6.2184672
更新日期:2012-12-01 00:00:00
abstract::Nineteen asymptomatic patients affected by isolated chronic aortic regurgitation received 20 mg of nifedipine sublingually: the acute hemodynamic effects of nifedipine were evaluated by combined cross-sectional and Doppler echocardiography. To assess variations in the regurgitant flow volume, the flow volume across th...
journal_title:Acta cardiologica
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract::In eighteen consecutive patients (14 male, 4 females, in the age 37-52 years, mean = 43 years) with dilated cardiomyopathy in NYHA functional classification groups III-IV, the efficacy of ambulatory long-term (mean = 6 years) vasodilator therapy by means mechanocardiography (systolic and diastolic time intervals) and ...
journal_title:Acta cardiologica
pub_type: 杂志文章
doi:
更新日期:1995-01-01 00:00:00
abstract::The combination of coarctation of the aorta in the presence of severe aortic insufficiency poses a serious clinical problem. Although successful single- and two-stage repair for combined coarctation in the presence of severe aortic regurgitation has been described, the surgical management of this lesion remains partic...
journal_title:Acta cardiologica
pub_type: 杂志文章
doi:
更新日期:1998-01-01 00:00:00
abstract::Indices of the first derivative and of the normalized first derivative of the left apexcardiogram were used to evaluate the contractile state of the left ventricle of cyclists in the competitive season compared to their resting season and of cardiac patients before and after a physical training program. In both groups...
journal_title:Acta cardiologica
pub_type: 杂志文章
doi:
更新日期:1983-01-01 00:00:00
abstract:OBJECTIVE:This study sought to evaluate the potential prognostic usefulness of QT dispersion (QTd) in patients with unstable angina. METHODS AND RESULTS:QTd was calculated and plasma troponin T (TnT) level was measured and rest perfusion imaging with Tc-99m sestamibi was performed in 62 patients admitted with chest pa...
journal_title:Acta cardiologica
pub_type: 杂志文章
doi:10.2143/AC.59.3.2005183
更新日期:2004-06-01 00:00:00
abstract::A clinical, electrocardiographic and coronarographic study of ten cases shows that surelevation of ST-segment during exercise (without any signs of infarction) correspond to very different clinical situations of anatomical state of coronary vessels, occurrence of coronary spasm and evolution of the ischemic disease. "...
journal_title:Acta cardiologica
pub_type: 杂志文章
doi:
更新日期:1977-01-01 00:00:00
abstract::Left ventricular (LV) asynchrony has been demonstrated to result in diastolic dysfunction. To test the hypothesis that altered LV synchrony interferes with LV diastolic function in essential hypertensive patients (HT), we performed radionuclide ventriculography and echocardiography in 38 HT and 11 normotensive subject...
journal_title:Acta cardiologica
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract:AIM:To determine whether statin therapy initiated early in acute myocardial infarction together with thrombolytic therapy in patients with acute myocardial infarction results in clinical benefit through early plaque stabilization. METHODS AND RESULTS:The study population consisted of 77 patients who underwent coronary...
journal_title:Acta cardiologica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.2143/AC.57.4.2005430
更新日期:2002-08-01 00:00:00
abstract::Extracorporeal Ultrafiltration Method (ECUM) could be used in patients with refractory congestive heart failure (CHF). We have encountered a 56-year-old woman with refractory congestive heart failure (CHF) (NYHA II-III) due to coronary artery disease, complicated by moderately advanced diabetic nephropathy (Cr = 2.4 m...
journal_title:Acta cardiologica
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract::The authors present a case of permanent atrial standstill with syncopal attacks, in a patient with chronic Chagas' Heart Disease. The recognition of this dysrhythmia was based upon the conventional and intracavity electrocardiographic tracings in addition to phonomecanographic and hemodynamic data. The recording of th...
journal_title:Acta cardiologica
pub_type: 杂志文章
doi:
更新日期:1975-01-01 00:00:00
abstract::Atherosclerotic involvement of extracoronary arteries in patients undergoing myocardial revascularization can cause severe postoperative complications and increase postoperative mortality. Between January and November 1998, routine preoperative echo-Doppler study of carotid vessels, abdominal aorta and iliac-femoral a...
journal_title:Acta cardiologica
pub_type: 杂志文章
doi:10.2143/AC.56.2.2005623
更新日期:2001-04-01 00:00:00
abstract:BACKGROUND:The effects of cigarette smoking on the circadian rhythm of heart rate variability (HRV) are not known. METHODS:We studied the effects of cigarette smoking on the circadian rhythm of HRV in 24 smoking and 21 non-smoking healthy subjects. Twenty-four hour ambulatory electrocardiograms were recorded and time ...
journal_title:Acta cardiologica
pub_type: 杂志文章
doi:10.2143/AC.55.5.2005757
更新日期:2000-10-01 00:00:00
abstract::Background: Few data are available on long-term atherothrombotic events after percutaneous transluminal angioplasty (PTA) for peripheral arterial disease (PAD). Restenosis after PTA may be a marker of a more aggressive atherothrombosis. Aim: To ascertain whether restenosis detected by duplex sonography (DUS) after PTA...
journal_title:Acta cardiologica
pub_type: 杂志文章
doi:10.1080/00015385.2019.1653565
更新日期:2019-08-15 00:00:00
abstract::Background: To explore the prognostic value of combination of coronary artery calcium scoring (CACS) and single-photon emission computed tomography (SPECT) on the long-term risk of major adverse cardiac events (MACEs) in Chinese patients at low risk of suspected coronary artery disease (CAD).Methods: The medical recor...
journal_title:Acta cardiologica
pub_type: 杂志文章
doi:10.1080/00015385.2018.1530081
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVE:In coronary artery disease, the implementation of a cardiac rehabilitation (CR) programme favourably affects cardiovascular prognosis. However, it remains uncertain whether patients benefit to a similar extent from CR after coronary artery bypass graft surgery (CABG) or percutaneous coronary intervention (PCI...
journal_title:Acta cardiologica
pub_type: 杂志文章
doi:10.2143/AC.64.5.2042694
更新日期:2009-10-01 00:00:00
abstract::Seven cases of an unusual type of ventricular arrhythmia, already named "Torsades de pointe" by French authors, are presented. It is characterized by a changing pattern of the ventricular complexes, spontaneous onset and cessation, and refractoriness to defibrillation and antiarrhythmic drugs which decrease intraventr...
journal_title:Acta cardiologica
pub_type: 杂志文章
doi:
更新日期:1978-01-01 00:00:00
abstract:BACKGROUND:The interest in transcatheter ventricular septal defect (VSD) closure is continuously growing. Therefore, we report our experience in perimembranous (Pm) and postinfarction (Pi) VSD closure. METHODS:All patients, older than 16 years, were selected from a data base, in which Pm and Pi VSDs were registered. T...
journal_title:Acta cardiologica
pub_type: 杂志文章
doi:10.2143/AC.62.4.2022283
更新日期:2007-08-01 00:00:00
abstract::Conventional repair of pararenal aortic aneurysms has been a technically challenging operation, with a significant morbidity rate of 28-35%. Endovascular stent grafting requires satisfactory landing zones for stent graft anchoring. Therefore, pararenal abdominal aortic aneurysms are usually contraindicated for this pr...
journal_title:Acta cardiologica
pub_type: 杂志文章
doi:10.1080/ac.69.4.3036661
更新日期:2014-08-01 00:00:00
abstract::Objective In modern cardiology practice, implantation of cardiac electronic devices in patients taking anticoagulant or antiplatelet therapy is a common clinical scenario. Bleeding complications are of particular concern in this patient population and pocket haematoma is one of the most frequent complications. We soug...
journal_title:Acta cardiologica
pub_type: 杂志文章
doi:10.1080/00015385.2017.1281539
更新日期:2017-02-01 00:00:00
abstract::"No-reflow" is an important complication of percutaneous coronary intervention (PCI) in the setting of acute myocardial infarction and is associated with worse outcomes. Visible thrombus on the angiogram is a significant risk factor for "no-reflow". A variety of strategies have been employed to prevent this phenomenon...
journal_title:Acta cardiologica
pub_type: 杂志文章
doi:10.2143/AC.60.6.2004941
更新日期:2005-12-01 00:00:00
abstract::The association between early atherosclerosis (IMT) and Atherogenic index of plasma (AIP), a marker of atherogenicity (log triglycerides/HDL Cholesterol) was evaluated in a population-based cohort study in women, aged 30-69, living in the metropolitan area of Naples, Southern Italy (Progetto ATENA). Serum cholesterol,...
journal_title:Acta cardiologica
pub_type: 杂志文章
doi:10.1080/00015385.2020.1858537
更新日期:2020-12-11 00:00:00
abstract:OBJECTIVES:Large pericardial effusions and cardiac tamponade are rare in childhood. The aim of this study was to evaluate the aetiological factors and clinical findings of large pericardial effusion and cardiac tamponade in children. METHODS:We reviewed retrospectively the records of 10 (6 male, 4 female) patients (me...
journal_title:Acta cardiologica
pub_type: 杂志文章
doi:10.2143/AC.62.2.2020232
更新日期:2007-04-01 00:00:00