Matches in SemOpenAlex for { <https://semopenalex.org/work/W2174124964> ?p ?o ?g. }
- W2174124964 endingPage "2488" @default.
- W2174124964 startingPage "2481" @default.
- W2174124964 abstract "BackgroundSuspected acute coronary syndrome is the commonest reason for emergency admission to hospital and is a large burden on health-care resources. Strategies to identify low-risk patients suitable for immediate discharge would have major benefits.MethodsWe did a prospective cohort study of 6304 consecutively enrolled patients with suspected acute coronary syndrome presenting to four secondary and tertiary care hospitals in Scotland. We measured plasma troponin concentrations at presentation using a high-sensitivity cardiac troponin I assay. In derivation and validation cohorts, we evaluated the negative predictive value of a range of troponin concentrations for the primary outcome of index myocardial infarction, or subsequent myocardial infarction or cardiac death at 30 days. This trial is registered with ClinicalTrials.gov (number NCT01852123).Findings782 (16%) of 4870 patients in the derivation cohort had index myocardial infarction, with a further 32 (1%) re-presenting with myocardial infarction and 75 (2%) cardiac deaths at 30 days. In patients without myocardial infarction at presentation, troponin concentrations were less than 5 ng/L in 2311 (61%) of 3799 patients, with a negative predictive value of 99·6% (95% CI 99·3–99·8) for the primary outcome. The negative predictive value was consistent across groups stratified by age, sex, risk factors, and previous cardiovascular disease. In two independent validation cohorts, troponin concentrations were less than 5 ng/L in 594 (56%) of 1061 patients, with an overall negative predictive value of 99·4% (98·8–99·9). At 1 year, these patients had a lower risk of myocardial infarction and cardiac death than did those with a troponin concentration of 5 ng/L or more (0·6% vs 3·3%; adjusted hazard ratio 0·41, 95% CI 0·21–0·80; p<0·0001).InterpretationLow plasma troponin concentrations identify two-thirds of patients at very low risk of cardiac events who could be discharged from hospital. Implementation of this approach could substantially reduce hospital admissions and have major benefits for both patients and health-care providers.FundingBritish Heart Foundation and Chief Scientist Office (Scotland). Suspected acute coronary syndrome is the commonest reason for emergency admission to hospital and is a large burden on health-care resources. Strategies to identify low-risk patients suitable for immediate discharge would have major benefits. We did a prospective cohort study of 6304 consecutively enrolled patients with suspected acute coronary syndrome presenting to four secondary and tertiary care hospitals in Scotland. We measured plasma troponin concentrations at presentation using a high-sensitivity cardiac troponin I assay. In derivation and validation cohorts, we evaluated the negative predictive value of a range of troponin concentrations for the primary outcome of index myocardial infarction, or subsequent myocardial infarction or cardiac death at 30 days. This trial is registered with ClinicalTrials.gov (number NCT01852123). 782 (16%) of 4870 patients in the derivation cohort had index myocardial infarction, with a further 32 (1%) re-presenting with myocardial infarction and 75 (2%) cardiac deaths at 30 days. In patients without myocardial infarction at presentation, troponin concentrations were less than 5 ng/L in 2311 (61%) of 3799 patients, with a negative predictive value of 99·6% (95% CI 99·3–99·8) for the primary outcome. The negative predictive value was consistent across groups stratified by age, sex, risk factors, and previous cardiovascular disease. In two independent validation cohorts, troponin concentrations were less than 5 ng/L in 594 (56%) of 1061 patients, with an overall negative predictive value of 99·4% (98·8–99·9). At 1 year, these patients had a lower risk of myocardial infarction and cardiac death than did those with a troponin concentration of 5 ng/L or more (0·6% vs 3·3%; adjusted hazard ratio 0·41, 95% CI 0·21–0·80; p<0·0001). Low plasma troponin concentrations identify two-thirds of patients at very low risk of cardiac events who could be discharged from hospital. Implementation of this approach could substantially reduce hospital admissions and have major benefits for both patients and health-care providers." @default.
- W2174124964 created "2016-06-24" @default.
- W2174124964 creator A5004488025 @default.
- W2174124964 creator A5004575218 @default.
- W2174124964 creator A5010016986 @default.
- W2174124964 creator A5015197962 @default.
- W2174124964 creator A5015528174 @default.
- W2174124964 creator A5019962152 @default.
- W2174124964 creator A5028873677 @default.
- W2174124964 creator A5041845028 @default.
- W2174124964 creator A5048131620 @default.
- W2174124964 creator A5052185363 @default.
- W2174124964 creator A5055262589 @default.
- W2174124964 creator A5059160963 @default.
- W2174124964 creator A5060701308 @default.
- W2174124964 creator A5061127067 @default.
- W2174124964 creator A5068500647 @default.
- W2174124964 creator A5071165691 @default.
- W2174124964 creator A5072868822 @default.
- W2174124964 creator A5074252129 @default.
- W2174124964 creator A5089362636 @default.
- W2174124964 date "2015-12-01" @default.
- W2174124964 modified "2023-10-16" @default.
- W2174124964 title "High-sensitivity cardiac troponin I at presentation in patients with suspected acute coronary syndrome: a cohort study" @default.
- W2174124964 cites W1877338411 @default.
- W2174124964 cites W1989806937 @default.
- W2174124964 cites W1992798089 @default.
- W2174124964 cites W2000787220 @default.
- W2174124964 cites W2009416104 @default.
- W2174124964 cites W2014012527 @default.
- W2174124964 cites W2040440192 @default.
- W2174124964 cites W2068704813 @default.
- W2174124964 cites W2077909649 @default.
- W2174124964 cites W2095447537 @default.
- W2174124964 cites W2096907419 @default.
- W2174124964 cites W2098316119 @default.
- W2174124964 cites W2105249780 @default.
- W2174124964 cites W2106578604 @default.
- W2174124964 cites W2113883406 @default.
- W2174124964 cites W2114198397 @default.
- W2174124964 cites W2133440648 @default.
- W2174124964 cites W2137761428 @default.
- W2174124964 cites W2142598336 @default.
- W2174124964 cites W2151231511 @default.
- W2174124964 cites W2152267722 @default.
- W2174124964 cites W2160843187 @default.
- W2174124964 cites W2165729583 @default.
- W2174124964 cites W2170406776 @default.
- W2174124964 cites W4211104669 @default.
- W2174124964 cites W4292856638 @default.
- W2174124964 doi "https://doi.org/10.1016/s0140-6736(15)00391-8" @default.
- W2174124964 hasPubMedCentralId "https://www.ncbi.nlm.nih.gov/pmc/articles/4765710" @default.
- W2174124964 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/26454362" @default.
- W2174124964 hasPublicationYear "2015" @default.
- W2174124964 type Work @default.
- W2174124964 sameAs 2174124964 @default.
- W2174124964 citedByCount "394" @default.
- W2174124964 countsByYear W21741249642015 @default.
- W2174124964 countsByYear W21741249642016 @default.
- W2174124964 countsByYear W21741249642017 @default.
- W2174124964 countsByYear W21741249642018 @default.
- W2174124964 countsByYear W21741249642019 @default.
- W2174124964 countsByYear W21741249642020 @default.
- W2174124964 countsByYear W21741249642021 @default.
- W2174124964 countsByYear W21741249642022 @default.
- W2174124964 countsByYear W21741249642023 @default.
- W2174124964 crossrefType "journal-article" @default.
- W2174124964 hasAuthorship W2174124964A5004488025 @default.
- W2174124964 hasAuthorship W2174124964A5004575218 @default.
- W2174124964 hasAuthorship W2174124964A5010016986 @default.
- W2174124964 hasAuthorship W2174124964A5015197962 @default.
- W2174124964 hasAuthorship W2174124964A5015528174 @default.
- W2174124964 hasAuthorship W2174124964A5019962152 @default.
- W2174124964 hasAuthorship W2174124964A5028873677 @default.
- W2174124964 hasAuthorship W2174124964A5041845028 @default.
- W2174124964 hasAuthorship W2174124964A5048131620 @default.
- W2174124964 hasAuthorship W2174124964A5052185363 @default.
- W2174124964 hasAuthorship W2174124964A5055262589 @default.
- W2174124964 hasAuthorship W2174124964A5059160963 @default.
- W2174124964 hasAuthorship W2174124964A5060701308 @default.
- W2174124964 hasAuthorship W2174124964A5061127067 @default.
- W2174124964 hasAuthorship W2174124964A5068500647 @default.
- W2174124964 hasAuthorship W2174124964A5071165691 @default.
- W2174124964 hasAuthorship W2174124964A5072868822 @default.
- W2174124964 hasAuthorship W2174124964A5074252129 @default.
- W2174124964 hasAuthorship W2174124964A5089362636 @default.
- W2174124964 hasBestOaLocation W21741249641 @default.
- W2174124964 hasConcept C118552586 @default.
- W2174124964 hasConcept C126322002 @default.
- W2174124964 hasConcept C144469398 @default.
- W2174124964 hasConcept C164705383 @default.
- W2174124964 hasConcept C188816634 @default.
- W2174124964 hasConcept C201903717 @default.
- W2174124964 hasConcept C2777698277 @default.
- W2174124964 hasConcept C2778213512 @default.
- W2174124964 hasConcept C2780724011 @default.
- W2174124964 hasConcept C36036425 @default.
- W2174124964 hasConcept C500558357 @default.