Abstract | BACKGROUND: METHODS: This prospective, single centre diagnostic FAME-ER study included patients presenting to the ED with symptoms suggestive of ACS. Blood was collected to measure biomarkers, notably, hs-cTnT was retrospectively assessed. Added value of markers was judged by increase in AUC using multivariable logistic regression. RESULTS: Of 453 patients enrolled, 149 (33%) received a final diagnosis of ACS. Hs-cTnT had the highest diagnostic value in both univariable and multivariable analysis. PPVs of the biomarkers ranged from 23.5% (PlGF) to 77.9% (hs-cTnT), NPVs from 67.0% (PlGF) to 86.4% (hs-cTnT). Only myoglobin yielded diagnostic value in addition to clinical symptoms and electrocardiography (ECG) (AUC of clinical model 0.80) with AUC of 0.84 (p<0.001). However, addition of hs-cTnT was superior (AUC 0.89, p<0.001). Addition of the biomarkers to our clinical model and hs-cTnT did not or only marginally (GDF-15) improved diagnostic performance. CONCLUSION: When assessing patients suspected of ACS, only myoglobin had added diagnostic value beyond clinical symptoms and ECG. However, when combined with hs-cTnT, it yields no additional diagnostic value. PlGF, sFlt-1, NT-proBNP, GDF-15 and copeptin had no added value to the clinical model or hs-cTnT.
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Authors | Judith M Poldervaart, Emma Röttger, Marieke S Dekker, Nicolaas P A Zuithoff, Peter W H M Verheggen, Evelyn A de Vrey, Thierry X Wildbergh, Arnoud W J van 't Hof, Arend Mosterd, Arno W Hoes |
Journal | PloS one
(PLoS One)
Vol. 10
Issue 7
Pg. e0132000
( 2015)
ISSN: 1932-6203 [Electronic] United States |
PMID | 26177390
(Publication Type: Journal Article)
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Chemical References |
- Biomarkers
- GDF15 protein, human
- Glycopeptides
- Growth Differentiation Factor 15
- PGF protein, human
- Peptide Fragments
- Pregnancy Proteins
- Troponin T
- copeptins
- pro-brain natriuretic peptide (1-76)
- Natriuretic Peptide, Brain
- Placenta Growth Factor
- FLT1 protein, human
- Vascular Endothelial Growth Factor Receptor-1
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Topics |
- Acute Coronary Syndrome
(blood, diagnosis)
- Aged
- Area Under Curve
- Biomarkers
(blood)
- Electrocardiography
- Female
- Glycopeptides
(blood)
- Growth Differentiation Factor 15
(blood)
- Humans
- Logistic Models
- Male
- Middle Aged
- Natriuretic Peptide, Brain
(blood)
- Odds Ratio
- Peptide Fragments
(blood)
- Placenta Growth Factor
- Pregnancy Proteins
(blood)
- Prospective Studies
- ROC Curve
- Sensitivity and Specificity
- Troponin T
(blood)
- Vascular Endothelial Growth Factor Receptor-1
(blood)
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