Age and Gender Tailored Cutoff Value of hs-cTnT Contributes to Rapidly Diagnose Acute Myocardial Infarction in Chest Pain Patients

Yang, Shuo; Huai, Wei; Qiao, Rui; Liyan, Cui; Liu, Guihua; Wu, Jian; Li, Aiwei; Zhang, Jie

doi:10.7754/clin.lab.2016.151201

Cited by 11 publications

(8 citation statements)

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“…These findings were also consistent with a recent Chinese study in which sex-specific cut-offs were calculated in an original reference population and then further stratified according to age. This study reports an increased specificity for sex-related hs-cTnT thresholds in the diagnostics of AMI, as well as higher negative and positive predictive values [95]. However, the impact of age-stratification probably played a decisive role in this study, still highlighting a possible interplay between these two variables.…”

Section: Application Of Sex-specific Cut-offs In Clinical Practicementioning

confidence: 75%

Sex-Specific Cut-Offs for High-Sensitivity Cardiac Troponin: Is Less More?

Romiti

Cangemi

Toriello

et al. 2019

Cardiovascular Therapeutics

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Management of patients presenting to the Emergency Department with chest pain is continuously evolving. In the setting of acute coronary syndrome, the availability of high-sensitivity cardiac troponin assays (hs-cTn) has allowed for the development of algorithms aimed at rapidly assessing the risk of an ongoing myocardial infarction. However, concerns were raised about the massive application of such a simplified approach to heterogeneous real-world populations. As a result, there is a potential risk of underdiagnosis in several clusters of patients, including women, for whom a lower threshold for hs-cTn was suggested to be more appropriate. Implementation in clinical practice of sex-tailored cut-off values for hs-cTn represents a hot topic due to the need to reduce inequality and improve diagnostic performance in females. The aim of this review is to summarize current evidence on sex-specific cut-off values of hs-cTn and their application and usefulness in clinical practice. We also offer an extensive overview of thresholds reported in literature and of the mechanisms underlying such differences among sexes, suggesting possible explanations about debated issues.

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Section: Application Of Sex-specific Cut-offs In Clinical Practicementioning

confidence: 75%

Sex-Specific Cut-Offs for High-Sensitivity Cardiac Troponin: Is Less More?

Romiti

Cangemi

Toriello

et al. 2019

Cardiovascular Therapeutics

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“…Another study showed that the downward adjustment of hs-cTn thresholds in women may be warranted to reduce the underdiagnosis of acute myocardial infarction in women [31]. It was also confirmed that revised cut-offs for hs-cTnT based on age and gender only improve the diagnostic performance rather than the prognostic risk prediction for death or other adverse events [32].…”

Section: Cardiac Troponinmentioning

confidence: 86%

The Biomarkers for Acute Myocardial Infarction and Heart Failure

Wang

Zhang

et al. 2020

BioMed Research International

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The use of a large number of cardiovascular biomarkers, meant to complement the use of the electrocardiogram, echocardiography cardiac imaging, and clinical symptom assessment, has become a routine in clinical diagnosis, differential diagnosis, risk stratification, and prognosis and guides the management of patients with suspected cardiovascular diseases. There is a broad consensus that cardiac troponin and natriuretic peptides are the preferred biomarkers in clinical practice for the diagnosis of the acute coronary syndrome and heart failure, respectively, while the roles and possible clinical applications of several other potential biomarkers are still under study. This review mainly focuses on the recent studies of the roles and clinical applications of troponin and natriuretic peptides, which seem to be the best-validated markers in distinguishing and predicting the future cardiac events of patients with suspected cardiovascular diseases. Additionally, the review briefly discusses some of the large number of potential markers that may play a more prominent role in the future.

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“…However, the clinical benefit of sex-specific diagnostic thresholds remains unproven with recent reports finding no long-term survival benefit despite increased MI and injury diagnoses in women. 18,19,[21][22][23][24]…”

Section: Importancementioning

confidence: 99%