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The feasibility and diagnostic accuracy by multiple cardiac biomarkers in emergency chest pain patients: a clinical analysis to compare 290 suspected acute coronary syndrome cases stratified by age and gender in Taiwan

BACKGROUND: Accurate diagnosis of acute coronary syndrome (ACS) in a timely fashion is challenging in the elderly population, especially elderly women, who usually exhibit atypical clinical symptoms. A multiple cardiac biomarker (MCB) based approach has been shown to improve diagnostic efficacy of A...

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Autores principales: Hung, Chung-Lieh, Chien, Ding-Kuo, Shih, Shou-Chuan, Chang, Wen-Han
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5055728/
https://www.ncbi.nlm.nih.gov/pubmed/27717317
http://dx.doi.org/10.1186/s12872-016-0374-4
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author Hung, Chung-Lieh
Chien, Ding-Kuo
Shih, Shou-Chuan
Chang, Wen-Han
author_facet Hung, Chung-Lieh
Chien, Ding-Kuo
Shih, Shou-Chuan
Chang, Wen-Han
author_sort Hung, Chung-Lieh
collection PubMed
description BACKGROUND: Accurate diagnosis of acute coronary syndrome (ACS) in a timely fashion is challenging in the elderly population, especially elderly women, who usually exhibit atypical clinical symptoms. A multiple cardiac biomarker (MCB) based approach has been shown to improve diagnostic efficacy of ACS. However, data in various age groups and sex differences remain largely unexplored. METHODS: Point-of-care testing (POCT) was performed on 290 patients (aged ≥18 years) who were admitted to the emergency department (ED) with symptoms of acute chest pain under suspicion of acute coronary syndrome (ACS). The MCB approach in current work assessed four cardiac biomarkers: myoglobin, troponin I, creatine kinase-myocardial band isoenzyme fraction (CK-MB), and brain natriuretic peptide (BNP). RESULTS: Overall, the MCB approach demonstrated considerably higher sensitivity for elderly patients than for younger patients in identifying ACS (80.0 % [64.1–90.0] vs. 52.6 % [37.3–67.5] for ≥65 years and <65 years groups), with younger population showed greater specificity (44.1 % [35.3–53.4] vs. 84.9 % [76.9–90.5] for ≥65 years and <65 years groups, respectively). The highest sensitivity achieved for elderly women who reported chest pain was 87.5 % [95 % CI: 64–96.5]). In general, the sensitivity of this approach was higher for female patients than for male patients (80 % [58.4–91.9] vs. 61 % [47.8–73.0]). CONCLUSIONS: The MCB approach can provide a quick and accurate clinical diagnosis in elderly and female patients, both of whom have traditionally proven to be challenging to diagnose from suspected acute coronary syndrome.
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spelling pubmed-50557282016-10-19 The feasibility and diagnostic accuracy by multiple cardiac biomarkers in emergency chest pain patients: a clinical analysis to compare 290 suspected acute coronary syndrome cases stratified by age and gender in Taiwan Hung, Chung-Lieh Chien, Ding-Kuo Shih, Shou-Chuan Chang, Wen-Han BMC Cardiovasc Disord Research Article BACKGROUND: Accurate diagnosis of acute coronary syndrome (ACS) in a timely fashion is challenging in the elderly population, especially elderly women, who usually exhibit atypical clinical symptoms. A multiple cardiac biomarker (MCB) based approach has been shown to improve diagnostic efficacy of ACS. However, data in various age groups and sex differences remain largely unexplored. METHODS: Point-of-care testing (POCT) was performed on 290 patients (aged ≥18 years) who were admitted to the emergency department (ED) with symptoms of acute chest pain under suspicion of acute coronary syndrome (ACS). The MCB approach in current work assessed four cardiac biomarkers: myoglobin, troponin I, creatine kinase-myocardial band isoenzyme fraction (CK-MB), and brain natriuretic peptide (BNP). RESULTS: Overall, the MCB approach demonstrated considerably higher sensitivity for elderly patients than for younger patients in identifying ACS (80.0 % [64.1–90.0] vs. 52.6 % [37.3–67.5] for ≥65 years and <65 years groups), with younger population showed greater specificity (44.1 % [35.3–53.4] vs. 84.9 % [76.9–90.5] for ≥65 years and <65 years groups, respectively). The highest sensitivity achieved for elderly women who reported chest pain was 87.5 % [95 % CI: 64–96.5]). In general, the sensitivity of this approach was higher for female patients than for male patients (80 % [58.4–91.9] vs. 61 % [47.8–73.0]). CONCLUSIONS: The MCB approach can provide a quick and accurate clinical diagnosis in elderly and female patients, both of whom have traditionally proven to be challenging to diagnose from suspected acute coronary syndrome. BioMed Central 2016-10-07 /pmc/articles/PMC5055728/ /pubmed/27717317 http://dx.doi.org/10.1186/s12872-016-0374-4 Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Hung, Chung-Lieh
Chien, Ding-Kuo
Shih, Shou-Chuan
Chang, Wen-Han
The feasibility and diagnostic accuracy by multiple cardiac biomarkers in emergency chest pain patients: a clinical analysis to compare 290 suspected acute coronary syndrome cases stratified by age and gender in Taiwan
title The feasibility and diagnostic accuracy by multiple cardiac biomarkers in emergency chest pain patients: a clinical analysis to compare 290 suspected acute coronary syndrome cases stratified by age and gender in Taiwan
title_full The feasibility and diagnostic accuracy by multiple cardiac biomarkers in emergency chest pain patients: a clinical analysis to compare 290 suspected acute coronary syndrome cases stratified by age and gender in Taiwan
title_fullStr The feasibility and diagnostic accuracy by multiple cardiac biomarkers in emergency chest pain patients: a clinical analysis to compare 290 suspected acute coronary syndrome cases stratified by age and gender in Taiwan
title_full_unstemmed The feasibility and diagnostic accuracy by multiple cardiac biomarkers in emergency chest pain patients: a clinical analysis to compare 290 suspected acute coronary syndrome cases stratified by age and gender in Taiwan
title_short The feasibility and diagnostic accuracy by multiple cardiac biomarkers in emergency chest pain patients: a clinical analysis to compare 290 suspected acute coronary syndrome cases stratified by age and gender in Taiwan
title_sort feasibility and diagnostic accuracy by multiple cardiac biomarkers in emergency chest pain patients: a clinical analysis to compare 290 suspected acute coronary syndrome cases stratified by age and gender in taiwan
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5055728/
https://www.ncbi.nlm.nih.gov/pubmed/27717317
http://dx.doi.org/10.1186/s12872-016-0374-4
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