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Cardiogoniometry as a diagnostic tool in patients with acute coronary syndromes: results of the CGM@ACS trial

BACKGROUND: Cardiogoniometry (CGM) is a novel electrocardiac method utilising computer-assisted three-dimensional information on cardiac potentials. OBJECTIVE: To investigate the potential of CGM in discriminating non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and relevant coronary sten...

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Autores principales: Tölg, Ralph, Zeymer, Uwe, Birkemeyer, Ralf, Wessely, Rainer, Eggebrecht, Holger, Bocksch, Wolfgang, Schneider, Steffen, Richardt, Gert, Hamm, Christian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer-Verlag 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3426668/
https://www.ncbi.nlm.nih.gov/pubmed/22485015
http://dx.doi.org/10.1007/s00392-012-0452-2
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author Tölg, Ralph
Zeymer, Uwe
Birkemeyer, Ralf
Wessely, Rainer
Eggebrecht, Holger
Bocksch, Wolfgang
Schneider, Steffen
Richardt, Gert
Hamm, Christian
author_facet Tölg, Ralph
Zeymer, Uwe
Birkemeyer, Ralf
Wessely, Rainer
Eggebrecht, Holger
Bocksch, Wolfgang
Schneider, Steffen
Richardt, Gert
Hamm, Christian
author_sort Tölg, Ralph
collection PubMed
description BACKGROUND: Cardiogoniometry (CGM) is a novel electrocardiac method utilising computer-assisted three-dimensional information on cardiac potentials. OBJECTIVE: To investigate the potential of CGM in discriminating non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and relevant coronary stenosis upon hospital admission by prospectively comparing its sensitivity, specificity and accuracy against those of a single troponin test and a 12-lead ECG performed on admission DESIGN: A multicenter prospective observational trial. SETTING: Eight interventional cardiac centres in Germany. PATIENTS: A cohort of 216 patients (mean age 67 years, 34.7 % female) who presented with acute chest pain or dyspnoea without ST-segment elevation and were scheduled for coronary angiography within 72 h of admission. INTERVENTION: Pre-angiography screening by CGM, troponin test, 12-lead ECG MAIN OUTCOME MEASURES: ECG, troponin and CGM on admission compared with final diagnosis of NSTE-ACS or relevant diameter stenosis ≥70 % verified by an independent review board and an angiographic core laboratory. RESULTS: NSTE-ACS was finally confirmed in 162 cases, whereas the remaining 54 cases without proof of NSTE-ACS served as controls. Diagnostic sensitivity for NSTE-ACS was 28, 50 and 69 % and specificity 78, 96 and 54 % for first ECG, serial troponin and first CGM, respectively. Accuracy was 40, 62 and 65 %. The sensitivity of the tests to detect relevant coronary stenosis (n = 126) was 32, 53 and 74 %, respectively. The sensitivity of CGM to detect NSTE-ACS (65 %) or relevant stenosis (71 %) was high even in patients with normal troponin and ECG. CONCLUSIONS: CGM can detect NSTE-ACS at first medical contact. CGM in conjunction with traditional markers, 12-lead ECG and troponin may effectively aid early decision making in patients presenting with acute chest pain.
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spelling pubmed-34266682012-08-29 Cardiogoniometry as a diagnostic tool in patients with acute coronary syndromes: results of the CGM@ACS trial Tölg, Ralph Zeymer, Uwe Birkemeyer, Ralf Wessely, Rainer Eggebrecht, Holger Bocksch, Wolfgang Schneider, Steffen Richardt, Gert Hamm, Christian Clin Res Cardiol Original Paper BACKGROUND: Cardiogoniometry (CGM) is a novel electrocardiac method utilising computer-assisted three-dimensional information on cardiac potentials. OBJECTIVE: To investigate the potential of CGM in discriminating non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and relevant coronary stenosis upon hospital admission by prospectively comparing its sensitivity, specificity and accuracy against those of a single troponin test and a 12-lead ECG performed on admission DESIGN: A multicenter prospective observational trial. SETTING: Eight interventional cardiac centres in Germany. PATIENTS: A cohort of 216 patients (mean age 67 years, 34.7 % female) who presented with acute chest pain or dyspnoea without ST-segment elevation and were scheduled for coronary angiography within 72 h of admission. INTERVENTION: Pre-angiography screening by CGM, troponin test, 12-lead ECG MAIN OUTCOME MEASURES: ECG, troponin and CGM on admission compared with final diagnosis of NSTE-ACS or relevant diameter stenosis ≥70 % verified by an independent review board and an angiographic core laboratory. RESULTS: NSTE-ACS was finally confirmed in 162 cases, whereas the remaining 54 cases without proof of NSTE-ACS served as controls. Diagnostic sensitivity for NSTE-ACS was 28, 50 and 69 % and specificity 78, 96 and 54 % for first ECG, serial troponin and first CGM, respectively. Accuracy was 40, 62 and 65 %. The sensitivity of the tests to detect relevant coronary stenosis (n = 126) was 32, 53 and 74 %, respectively. The sensitivity of CGM to detect NSTE-ACS (65 %) or relevant stenosis (71 %) was high even in patients with normal troponin and ECG. CONCLUSIONS: CGM can detect NSTE-ACS at first medical contact. CGM in conjunction with traditional markers, 12-lead ECG and troponin may effectively aid early decision making in patients presenting with acute chest pain. Springer-Verlag 2012-04-07 2012 /pmc/articles/PMC3426668/ /pubmed/22485015 http://dx.doi.org/10.1007/s00392-012-0452-2 Text en © The Author(s) 2012 https://creativecommons.org/licenses/by/4.0/ This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
spellingShingle Original Paper
Tölg, Ralph
Zeymer, Uwe
Birkemeyer, Ralf
Wessely, Rainer
Eggebrecht, Holger
Bocksch, Wolfgang
Schneider, Steffen
Richardt, Gert
Hamm, Christian
Cardiogoniometry as a diagnostic tool in patients with acute coronary syndromes: results of the CGM@ACS trial
title Cardiogoniometry as a diagnostic tool in patients with acute coronary syndromes: results of the CGM@ACS trial
title_full Cardiogoniometry as a diagnostic tool in patients with acute coronary syndromes: results of the CGM@ACS trial
title_fullStr Cardiogoniometry as a diagnostic tool in patients with acute coronary syndromes: results of the CGM@ACS trial
title_full_unstemmed Cardiogoniometry as a diagnostic tool in patients with acute coronary syndromes: results of the CGM@ACS trial
title_short Cardiogoniometry as a diagnostic tool in patients with acute coronary syndromes: results of the CGM@ACS trial
title_sort cardiogoniometry as a diagnostic tool in patients with acute coronary syndromes: results of the cgm@acs trial
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3426668/
https://www.ncbi.nlm.nih.gov/pubmed/22485015
http://dx.doi.org/10.1007/s00392-012-0452-2
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