The DOI matches its Crossref record; 3 of the 3 references it cites were found in a registry or an index.
Rapid Rule-out of Acute Myocardial Infarction With a Single High-Sensitivity Cardiac Troponin T Measurement Below the Limit of Detection: A Collaborative Meta-analysis
Open accessAbstract
Background: High-sensitivity assays for cardiac troponin T (hs-cTnT) are sometimes used to rapidly rule out acute myocardial infarction (AMI). Purpose: To estimate the ability of a single hs-cTnT concentration below the limit of detection (<0.005 µg/L) and a nonischemic electrocardiogram (ECG) to rule out AMI in adults presenting to the emergency department (ED) with chest pain. Data Sources: EMBASE and MEDLINE without language restrictions (1 January 2008 to 14 December 2016). Study Selection: Cohort studies involving adults presenting to the ED with possible acute coronary syndrome in whom an ECG and hs-cTnT measurements were obtained and AMI outcomes adjudicated during initial hospitalization. Data Extraction: Investigators of studies provided data on the number of low-risk patients (no new ischemia on ECG and hs-cTnT measurements <0.005 µg/L) and the number who had AMI during hospitalization (primary outcome) or a major adverse cardiac event (MACE) or death within 30 days (secondary outcomes), by risk classification (low or not low risk). Two independent epidemiologists rated risk of bias of studies. Data Synthesis: Of 9241 patients in 11 cohort studies, 2825 (30.6%) were classified as low risk. Fourteen (0.5%) low-risk patients had AMI. Sensitivity of the risk classification for AMI ranged from 87.5% to 100% in individual studies. Pooled estimated sensitivity was 98.7% (95% CI, 96.6% to 99.5%). Sensitivity for 30-day MACEs ranged from 87.9% to 100%; pooled sensitivity was 98.0% (CI, 94.7% to 99.3%). No low-risk patients died. Limitation: Few studies, variation in timing and methods of reference standard troponin tests, and heterogeneity of risk and prevalence of AMI across studies. Conclusion: A single hs-cTnT concentration below the limit of detection in combination with a nonischemic ECG may successfully rule out AMI in patients presenting to EDs with possible emergency acute coronary syndrome. Primary Funding Source: Emergency Care Foundation.
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Cites
QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies
Whiting, P. F., Rutjes, A. W. S., Westwood, M. E., Mallett, S., Deeks, J. J., Reitsma, J. B., Leeflang, M. M. G., Sterne, J. A. C., Bossuyt, P. M. M., & the QUADAS-2 Group* (2011) · Annals of Internal Medicine · doi:10.7326/0003-4819-155-8-201110180-00009 · Cited by 14,199
Reitsma, J. B., Glas, A. S., Rutjes, A. W. S., Scholten, R. J. P. M., Bossuyt, P. M., & Zwinderman, A. H. (2005) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2005.02.022 · Cited by 3,369
A Re-Evaluation of Random-Effects Meta-Analysis
Higgins, J. P. T., Thompson, S. G., & Spiegelhalter, D. J. (2009) · Journal of the Royal Statistical Society Series A: Statistics in Society · doi:10.1111/j.1467-985x.2008.00552.x · Cited by 2,569 · cited 1×
“I(2) values less than 25%, 25% to less than 75%, and 75% or greater were considered to represent low, moderate, and high heterogeneity, respectively (16).”
Background
Cited by
2023 ESC Guidelines for the management of acute coronary syndromes
Byrne, R. A., Rossello, X., Coughlan, J. J., Barbato, E., Berry, C., Chieffo, A., Claeys, M. J., Dan, G.-A., Dweck, M. R., Galbraith, M., et al. (2023) · European Heart Journal · doi:10.1093/eurheartj/ehad191 · Cited by 5,333
Self-citationCollet, J.-P., Thiele, H., Barbato, E., Barthélémy, O., Bauersachs, J., Bhatt, D. L., Dendale, P., Dorobantu, M., Edvardsen, T., Folliguet, T., et al. (2021) · European Heart Journal · doi:10.1093/eurheartj/ehaa575 · Cited by 5,037
Self-citationApplication of High-Sensitivity Troponin in Suspected Myocardial Infarction
Neumann, J. T., Twerenbold, R., Ojeda, F., Sörensen, N. A., Chapman, A. R., Shah, A. S. V., Anand, A., Boeddinghaus, J., Nestelberger, T., Badertscher, P., et al. (2019) · New England Journal of Medicine · doi:10.1056/nejmoa1803377 · Cited by 346
Self-citationSandoval, Y., Apple, F. S., Mahler, S. A., Body, R., Collinson, P. O., Jaffe, A. S., & on behalf of the International Federation of Clinical Chemistry and Laboratory Medicine Committee on the Clinical Application of Cardiac Biomarkers (2022) · Circulation · doi:10.1161/circulationaha.122.059678 · Cited by 202
Self-citationClinical utility of magnetocardiography in cardiology for the detection of myocardial ischemia
Camm, A. J., Henderson, R., Brisinda, D., Body, R., Charles, R. G., Varcoe, B., & Fenici, R. (2019) · Journal of Electrocardiology · doi:10.1016/j.jelectrocard.2019.07.009 · Cited by 42
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Metadata
- Authors
- Pickering, J. W., Than, M. P., Cullen, L., Aldous, S., ter Avest, E., Body, R., Carlton, E. W., Collinson, P., Dupuy, A. M., Ekelund, U., Eggers, K. M., Florkowski, C. M., Freund, Y., George, P., Goodacre, S., Greenslade, J. H., Jaffe, A. S., Lord, S. J., Mokhtari, A., Mueller, C., Munro, A., Mustapha, S., Parsonage, W., Peacock, W. F., Pemberton, C., Richards, A. M., Sanchis, J., Staub, L. P., Troughton, R., Twerenbold, R., Wildi, K., & Young, J.
- Venue
- Annals of Internal Medicine
- Publisher
- American College of Physicians
- Published
- 2017-05-16
- Volume
- 166
- Issue
- 10
- Pages
- 715-724
- ISSN
- 0003-4819 (ISSN-L)
- 1539-3704
- OpenAlex
- W2614495315
- Cited by
- 290
- References
- 3
- FWCI
- 26.27
- Type
- journal article
- Language
- en
- Open access
- green
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- CoChat. (2026). Citation check: Rapid Rule-out of Acute Myocardial Infarction With a Single High-Sensitivity Cardiac Troponin T Measurement Below the Limit of Detection: A Collaborative Meta-analysis. https://app.cochat.ai/papers/10.7326/m16-2562
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- Pickering, J. W., Than, M. P., Cullen, L., Aldous, S., ter Avest, E., Body, R., Carlton, E. W., Collinson, P., Dupuy, A. M., Ekelund, U., Eggers, K. M., Florkowski, C. M., Freund, Y., George, P., Goodacre, S., Greenslade, J. H., Jaffe, A. S., Lord, S. J., Mokhtari, A., . . . Young, J. (2017). Rapid Rule-out of Acute Myocardial Infarction With a Single High-Sensitivity Cardiac Troponin T Measurement Below the Limit of Detection: A Collaborative Meta-analysis. Annals of Internal Medicine. https://doi.org/10.7326/m16-2562
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
