InteraksyonDo marathons damage your heart? Decade-long study finally settles the debate
John PickeringI have just read an article advocating for a higher #troponin threshold for rule-out of #MyocardialInfarction in #EmergencyDepartment patients (https://www.hindawi.com/journals/emi/2024/2241528/). The paper makes the mistake of using #NegativePredictiveValue rather the #Sensitivity for assessing algorithm safety. Consequently, they advocate for a threshold that would miss 1 in 25 #MI.
The journal does not allow letters to the editor, so I have included one here.
#EmergencyRoom
The journal does not allow letters to the editor, so I have included one here.
#EmergencyRoom
For #ED, #Cardiology, & #biochemistry colleagues. Just published in #ClinicalChemistry we show that the precision with which we measure #troponin concentrations can be quite poor at the low end without adversely affecting safety of diagnostic pathways to rule-out #MyocardialInfarction.
https://academic.oup.com/clinchem/advance-article-abstract/doi/10.1093/clinchem/hvae059/7665905?utm_source=advanceaccess&utm_campaign=clinchem&utm_medium=email
It also means the #FDA can relax their reporting restrictions to not <Limit of Quantitation (but will they?)
https://academic.oup.com/clinchem/advance-article-abstract/doi/10.1093/clinchem/hvae059/7665905?utm_source=advanceaccess&utm_campaign=clinchem&utm_medium=email
It also means the #FDA can relax their reporting restrictions to not <Limit of Quantitation (but will they?)
Howard Smith MD, AMTroponin Levels Assess Cardiovascular Risks: Serial measurements demonstrate HBP therapy effectiveness and risk of other cardiovascular risks. #troponin #hypertension #heartattack #heartfailure #stroke
https://www.instagram.com/p/C48iOblL6jD/
https://www.instagram.com/p/C48iOblL6jD/
I'm struggling to connect to #EmergencyMedicine researchers on Mastodon. Maybe this #infographic of our latest research on point-of-care #troponin in the #EmergencyRoom will do it.
#EmergencyDepartment #ER #ED
#EmergencyDepartment #ER #ED
RichardBodyTroponin is NOT a marker of myocardial infarction #myocardialinfarction #health #shorts #troponin
https://youtube.com/shorts/r1xScsD5pXo?feature=share
https://youtube.com/shorts/r1xScsD5pXo?feature=share
Troponin is NOT a marker of myocardial infarction #myocardialinfarction #health #shorts #troponin
AMPEL-CDSSKey findings:
- age and sex had a significant effect on the 99th percentile of serum hs-cTnT concentration in both cohorts
- hospitalization is associated with higher hs-cTnT levels in in most age groups than in individuals in the general population, even in patients without diagnosed or suspected heart disease
- age- and sex-specific hs-cTnT reference values may be beneficial for hospitalized patients
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The study included two independent cohorts: a population-based cohort of 9 882 healthy subjects from the LIFE-Adult study in Leipzig, and a hospital-based cohort of 43 328 patients from Leipzig University Hospital. In both cohorts, subjects with suspected or diagnosed cardiac disease were excluded.
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Just out in @naturemedicine Diagnosis of #MyocardialInfarction in the #ED with #MachineLearning https://rdcu.be/dbUSl #EmergencyMedicine #Troponin
Our recent study about troponin thresholds (https://doi.org/10.3390/jcm10235508) shows the large differences in age- and sex-specific reference ranges. Young women are systematically underdiagnosed. The study by Arslani & Tontsch et al (described before) now suggests that this may lead to increased mortality in young women.
Gender and age-specific adjustment of troponin thresholds, is easy to accomplish, has low costs, and is likely to save lives.
#SexBias #Patientsafety #Troponin #AMI #CDSS #AMPEL
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Revisited Upper Reference Limits for Highly Sensitive Cardiac Troponin T in Relation to Age, Sex, and Renal Function
(1) Background: Highly sensitive cardiac troponin T (hs-cTnT) plays an essential role in the diagnosis of myocardial injury. The upper reference limit of the respective assay is generally applied, irrespective of age, renal function, or sex. We aimed to identify age-adjusted and sex-adjusted upper reference limits in relation to renal function in a large population-based cohort without cardiac diseases. (2) Methods: We included 5428 subjects of the population-based LIFE-Adult cohort, free of diagnosed cardiac diseases. Sex-adjusted and age-adjusted 99th percentiles for hs-cTnT in subjects with preserved renal function were obtained. (3) Results: The hs-cTnT values were higher in men of all age groups. In both sexes, an increasing age positively correlated with higher hs-cTnT values. Hs-cTnT weakly correlated with serum creatinine. The three-dimensional analysis of age, creatinine, and hs-cTnT showed no relevant additional effect of creatinine on hs-cTnT. In men aged above 60 and women above 70, the calculated 99th percentiles clearly exceeded the commonly applied thresholds. (4) Conclusion: Age and sex have a major impact on the serum concentration of hs-cTnT, while renal function does not. We propose to consider age-adjusted and sex-adjusted reference values.