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• W3204408101 abstract "Background. Glucose is emerging as a biomarker for early and safe rule-out of acute myocardial infarction in emergency department (ED) chest pain patients. We evaluated the diagnostic accuracy of dual testing with high sensitivity TnT (hs-cTnT) and glucose for prediction of major adverse cardiac events (MACE) within 30 days. Methods. This was a secondary analysis of a single-center prospective observational study of 1167 ED chest-pain patients with hs-cTnT and glucose testing at presentation (0 h), and hs-cTnT 1 h later. We tested the addition of glucose <5.6 mmol/L to three MACE rule-out strategies: hs-cTnT <5 ng/L, ≤14 ng/L or a 0 h/1h algorithm, i.e. initial hs-cTnT <12 ng/L with a 1 h change of <3 ng/L. We also tested the addition of glucose ≥11mmol/L to three rule-in strategies: hs-cTnT ≥52 ng/L, a 1 h change ≥5 ng/L or hs-cTnT >14 ng/L. The outcomes were 30-day MACE and 30-day MACE without UA. Results. Two dual-testing approaches reached our target NPV for rule-out: A 0 h hs-cTnT ≤14 ng/L and glucose <5.6 mmol/L identified 252 patients (24.4%) with a 98.8% NPV for 30-day MACE and 99.6% for MACE without UA. The 0 h/1h hs-cTnT algorithm combined with glucose identified 240 patients (23.2%) with a 99.2% NPV for 30-day MACE and 100.0% for MACE without UA. No dual rule-in strategy performed better than using hs-cTnT alone. Conclusions. A combination of hs-cTnT and blood glucose at presentation can be used to identify almost ¼ of ED chest pain patients with a very low risk of 30-day MACE where further testing is not needed. Adding glucose did not improve the rule-in of 30-day MACE." @default.
• W3204408101 created "2021-10-11" @default.
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• W3204408101 date "2021-10-07" @default.
• W3204408101 modified "2023-09-23" @default.
• W3204408101 title "Glucose and high-sensitivity troponin T predict a low risk of major adverse cardiac events in emergency department chest pain patients" @default.
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• W3204408101 doi "https://doi.org/10.1080/14017431.2021.1987512" @default.
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