Impact of European Society of Cardiology/American College of Cardiology                guidelines on diagnostic classification of patients with suspected acute coronary                syndromes

Collinson, Paul; Rao, A C R; Canepa‐Anson, R; Joseph, S P

doi:10.1258/000456303763046085

Cited by 18 publications

(8 citation statements)

References 16 publications

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“…This finding is explained by the fact that troponin is considerably more sensitive than CK or CK-MB in detecting even small areas of myocardial infarction. Thus, the use of troponin categorises more patients as having suffered myocardial infarction, which would have been diagnosed with angina pectoris or unstable angina using the less sensitive markers CK and CK-MB 26. Compared with older biomarkers, H-FABP performs better, showing higher sensitivity, whereas in comparison with troponin, its sensitivity for detecting myocardial infarction will be lower.…”

Section: Discussionmentioning

confidence: 99%

Heart-type fatty acid-binding protein in the early diagnosis of acute myocardial infarction: a systematic review and meta-analysis

Slot

Reitsma

Rutten

et al. 2010

Heart

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Heart-type fatty acid-binding protein in the early diagnosis of acute myocardial infarction: a systematic review and meta-analysis Bruins Slot, M.H.E.; Reitsma, J.B.; Rutten, F.H.; Hoes, A.W.; van der Heijden, G.J.M.G. General rightsIt is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulationsIf you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library: http://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible. Download date: 28 Apr 2019Heart-type fatty acid-binding protein in the early diagnosis of acute myocardial infarction: a systematic review and meta-analysis Main outcome measures A summary estimate for sensitivity and specificity was calculated using the bivariate random-effects approach, and covariate analysis was used to examine sources of heterogeneity between studies.Results A systematic search yielded 16 studies (3709 patients, prevalence of AMI 13e74%, male gender 49e84%, median age 64e76 years). The summary estimate was 84% (95% CI 76% to 90%) for sensitivity and 84% (95% CI 76% to 89%) for specificity. Covariate analyses revealed that the use of troponin in the reference standard for AMI (as opposed to creatine kinase or creatine kinase-myocardial band) had a significant impact on sensitivity. Conclusion H-FABP does not fulfil the requirements needed for a safe and early diagnosis of AMI when used as a stand-alone test. Sound diagnostic studies examining the additional role of H-FABP combined with clinical findings and other diagnostic tests are needed to further clarify a potential future role for this cardiac biomarker.

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Section: Discussionmentioning

confidence: 99%

Heart-type fatty acid-binding protein in the early diagnosis of acute myocardial infarction: a systematic review and meta-analysis

Slot

Reitsma

Rutten

et al. 2010

Heart

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“…Collinson et al [30] recently showed that 5% of all admission for suspected ACS in their hospital were incorrectly classified as MI using the traditional WHO criteria. The potential annual drug cost for treatment of these patients as MI patients, when projected to their annual caseload of 4500 patients, was approximately 56 000 pounds, with a 10-year estimated cost close to half million pounds in wasted resources [30].…”

Section: Impact Of Changing Diagnostic Criteriamentioning

confidence: 99%

The new definition of myocardial infarction and the impact of troponin determination on clinical practice

Panteghini

2006

International Journal of Cardiology

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“…Collinson et al [50] estimated that ~5% of all hospital admissions, who were diagnosed as non-ST elevation MI with World Health Organisation enzymatic criteria, had actually normal cTn values that classified them as false positive. The potential annual drug cost for treatment of these cases as MI patients was estimated to be approximately £56,000, with a 10-year estimated cost close to half a million pounds in wasted resources [50].…”

Section: Introducing Cardiac Troponin: a Paradigm Example Of The Labomentioning

confidence: 99%

“…The potential annual drug cost for treatment of these cases as MI patients was estimated to be approximately £56,000, with a 10-year estimated cost close to half a million pounds in wasted resources [50]. Together with the introduction of new biomarkers that significantly impact health outcomes, laboratory professionals assume a central role in removing from the menu those tests that have become obsolete and useless.…”

Section: Introducing Cardiac Troponin: a Paradigm Example Of The Labomentioning

confidence: 99%

Laboratory medicine in the new healthcare environment

Ferraro

Braga

Panteghini

2016

Clinical Chemistry and Laboratory Medicine (CCLM)

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Abstract:The 21st century challenge is to redesign healthcare systems to be safe, efficient, effective, timely, equitable and patient-centred. Although laboratory medicine is integral to many of these objectives involving prevention, diagnosis, treatment, and managing disease of patients, it suffers from poor visibility as a medical discipline and as a profession and fewer rewards for educational efforts when compared to other medical disciplines. Laboratory scientists are often perceived as managing machinery and equipment, but conversely they need to take a position of shared clinical leadership, showing the role of laboratory tests to guarantee optimal care for patients. This is however challenging because of some reluctance by laboratory professionals to involve themselves in test structuring and requesting and in the inspection of work as it arrives because it is assumed that all requests are clinically necessary; there is a poor communication and integration between clinical wards and laboratory; and, importantly, there is the need for an excellent cultural and scientific background of laboratory professionals for implementing outcome research and to act as knowledge managers and skilled clinical consultants. By combining the unique talent of performing quality laboratory assays with knowledge of the pathophysiologic rationale behind the tests, laboratory professionals have the expertise to advise their clinical colleagues in regard to the appropriate test selection and interpretation of laboratory results, thereby creating opportunities to define the added value and the pivotal role of laboratory medicine on healthcare delivery.

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Impact of European Society of Cardiology/American College of Cardiology guidelines on diagnostic classification of patients with suspected acute coronary syndromes

Abstract: Background Assessment of the relative diagnostic accuracy of investigation strategies for patients with suspected acute coronary syndromes (ACS).

Cited by 18 publications

References 16 publications

Heart-type fatty acid-binding protein in the early diagnosis of acute myocardial infarction: a systematic review and meta-analysis

Heart-type fatty acid-binding protein in the early diagnosis of acute myocardial infarction: a systematic review and meta-analysis

The new definition of myocardial infarction and the impact of troponin determination on clinical practice

Laboratory medicine in the new healthcare environment

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