Cargando…
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...
Autores principales: | , , , , , , , , |
---|---|
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 |
_version_ | 1782241533153509376 |
---|---|
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. |
format | Online Article Text |
id | pubmed-3426668 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | Springer-Verlag |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT tolgralph cardiogoniometryasadiagnostictoolinpatientswithacutecoronarysyndromesresultsofthecgmacstrial AT zeymeruwe cardiogoniometryasadiagnostictoolinpatientswithacutecoronarysyndromesresultsofthecgmacstrial AT birkemeyerralf cardiogoniometryasadiagnostictoolinpatientswithacutecoronarysyndromesresultsofthecgmacstrial AT wesselyrainer cardiogoniometryasadiagnostictoolinpatientswithacutecoronarysyndromesresultsofthecgmacstrial AT eggebrechtholger cardiogoniometryasadiagnostictoolinpatientswithacutecoronarysyndromesresultsofthecgmacstrial AT bockschwolfgang cardiogoniometryasadiagnostictoolinpatientswithacutecoronarysyndromesresultsofthecgmacstrial AT schneidersteffen cardiogoniometryasadiagnostictoolinpatientswithacutecoronarysyndromesresultsofthecgmacstrial AT richardtgert cardiogoniometryasadiagnostictoolinpatientswithacutecoronarysyndromesresultsofthecgmacstrial AT hammchristian cardiogoniometryasadiagnostictoolinpatientswithacutecoronarysyndromesresultsofthecgmacstrial |