Identification of acute myocardial infarction in elderly patients using optimized highly sensitive troponin I thresholds

Purpose: Established diagnostic thresholds for high-sensitivity cardiac troponins (hs-cTn) might not apply for elderly patients as they are elevated irrespective of the presence of an acute myocardial infarction (AMI). Aim of the present study was to investigate hs-cTnI in elderly patients with susp...

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Published in:Biomarkers 2019-08, Vol.24 (6), p.549-555
Main Authors: von Jeinsen, Beatrice, Liebetrau, Christoph, Palapies, Lars, Tzikas, Stergios, Zeller, Tanja, Bickel, Christoph, Schmidt, Alexander, Tubaro, Marco, Lackner, Karl J., Sar, Fachrie, Baldus, Stephan, Zeiher, Andreas M., Blankenberg, Stefan, Gori, Tommaso, Münzel, Thomas, Hamm, Christian W., Wild, Philipp S., Keller, Till
Format: Article
Language:English
Subjects:
Acute myocardial infarction
Adult
age
Aged
Aged, 80 and over
biomarkers
Biomarkers - blood
elderly
Female
Humans
Hyperlipidemias - blood
Hyperlipidemias - diagnosis
Hyperlipidemias - physiopathology
Hypertension - blood
Hypertension - diagnosis
Hypertension - physiopathology
Male
Middle Aged
Myocardial Infarction - blood
Myocardial Infarction - diagnosis
Myocardial Infarction - physiopathology
Prospective Studies
Risk Factors
Sensitivity and Specificity
Smoking - blood
Smoking - physiopathology
troponin
Troponin I - blood
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Summary:Purpose: Established diagnostic thresholds for high-sensitivity cardiac troponins (hs-cTn) might not apply for elderly patients as they are elevated irrespective of the presence of an acute myocardial infarction (AMI). Aim of the present study was to investigate hs-cTnI in elderly patients with suspected AMI and to calculate optimized diagnostic cutoffs. Material and methods: Data from a prospective multi-centre study and from a second independent prospective single-centre cohort study were analysed. A number of 2903 patients were eligible for further analysis. Patients > 70 years were classified as elderly. hs-cTnI was measured upon admission. Results: Around 34.7% of 2903 patients were classified as elderly. Around 22.5% of elderly patients were finally diagnosed with AMI. Elderly patients had higher hs-cTnI levels at admission irrespective of the final diagnosis (p 
ISSN:1354-750X
1366-5804
DOI:10.1080/1354750X.2019.1606276