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Prospective validation of a 1-hour algorithm to rule-out and rule-in acute myocardial infarction using a high-sensitivity cardiac troponin T assay

Overview of attention for article published in Canadian Medical Association Journal, April 2015
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  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (98th percentile)
  • High Attention Score compared to outputs of the same age and source (94th percentile)

Mentioned by

news
5 news outlets
blogs
3 blogs
twitter
69 X users
patent
1 patent
facebook
7 Facebook pages
googleplus
1 Google+ user

Citations

dimensions_citation
196 Dimensions

Readers on

mendeley
193 Mendeley
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Title
Prospective validation of a 1-hour algorithm to rule-out and rule-in acute myocardial infarction using a high-sensitivity cardiac troponin T assay
Published in
Canadian Medical Association Journal, April 2015
DOI 10.1503/cmaj.141349
Pubmed ID
Authors

Tobias Reichlin, Raphael Twerenbold, Karin Wildi, Maria Rubini Gimenez, Nathalie Bergsma, Philip Haaf, Sophie Druey, Christian Puelacher, Berit Moehring, Michael Freese, Claudia Stelzig, Lian Krivoshei, Petra Hillinger, Cedric Jäger, Thomas Herrmann, Philip Kreutzinger, Milos Radosavac, Zoraida Moreno Weidmann, Kateryna Pershyna, Ursina Honegger, Max Wagener, Thierry Vuillomenet, Isabel Campodarve, Roland Bingisser, Òscar Miró, Katharina Rentsch, Stefano Bassetti, Stefan Osswald, Christian Mueller

Abstract

We aimed to prospectively validate a novel 1-hour algorithm using high-sensitivity cardiac troponin T measurement for early rule-out and rule-in of acute myocardial infarction (MI). In a multicentre study, we enrolled 1320 patients presenting to the emergency department with suspected acute MI. The highsensitivity cardiac troponin T 1-hour algorithm, incorporating baseline values as well as absolute changes within the first hour, was validated against the final diagnosis. The final diagnosis was then adjudicated by 2 independent cardiologists using all available information, including coronary angiography, echocardiography, follow-up data and serial measurements of high-sensitivity cardiac troponin T levels. Acute MI was the final diagnosis in 17.3% of patients. With application of the high-sensitivity cardiac troponin T 1-hour algorithm, 786 (59.5%) patients were classified as "rule-out," 216 (16.4%) were classified as "rule-in" and 318 (24.1%) were classified to the "observational zone." The sensitivity and the negative predictive value for acute MI in the rule-out zone were 99.6% (95% confidence interval [CI] 97.6%-99.9%) and 99.9% (95% CI 99.3%-100%), respectively. The specificity and the positive predictive value for acute MI in the rule-in zone were 95.7% (95% CI 94.3%-96.8%) and 78.2% (95% CI 72.1%-83.6%), respectively. The 1-hour algorithm provided higher negative and positive predictive values than the standard interpretation of high-sensitivity cardiac troponin T using a single cut-off level (both p < 0.05). Cumulative 30-day mortality was 0.0%, 1.6% and 1.9% in patients classified in the rule-out, observational and rule-in groups, respectively (p = 0.001). This rapid strategy incorporating high-sensitivity cardiac troponin T baseline values and absolute changes within the first hour substantially accelerated the management of suspected acute MI by allowing safe rule-out as well as accurate rule-in of acute MI in 3 out of 4 patients. Clinical Trials.gov, NCT00470587.

X Demographics

X Demographics

The data shown below were collected from the profiles of 69 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 193 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 2 1%
Denmark 1 <1%
Australia 1 <1%
Unknown 189 98%

Demographic breakdown

Readers by professional status Count As %
Researcher 24 12%
Other 23 12%
Student > Doctoral Student 21 11%
Student > Master 19 10%
Student > Postgraduate 18 9%
Other 52 27%
Unknown 36 19%
Readers by discipline Count As %
Medicine and Dentistry 125 65%
Biochemistry, Genetics and Molecular Biology 6 3%
Agricultural and Biological Sciences 5 3%
Nursing and Health Professions 4 2%
Pharmacology, Toxicology and Pharmaceutical Science 3 2%
Other 8 4%
Unknown 42 22%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 101. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 19 October 2021.
All research outputs
#415,001
of 25,330,051 outputs
Outputs from Canadian Medical Association Journal
#735
of 9,415 outputs
Outputs of similar age
#4,666
of 271,414 outputs
Outputs of similar age from Canadian Medical Association Journal
#7
of 106 outputs
Altmetric has tracked 25,330,051 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 98th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 9,415 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 34.0. This one has done particularly well, scoring higher than 92% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 271,414 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 98% of its contemporaries.
We're also able to compare this research output to 106 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 94% of its contemporaries.