Serial multiple biomarkers in the assessment of suspected acute coronary syndrome: multiple infarct markers in chest pain (MIMIC) study

Macdonald, Stephen; Nagree, Yusuf; Fatovich, Daniel M; Phillips, Michael; Brown, Simon G A

doi:10.1136/emermed-2011-200667

Cited by 9 publications

(12 citation statements)

References 29 publications

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“…Troponins are the most cardio-specific and sensitive biomarkers of myocardial damage, according to the new universal definition of myocardial infarction [15,23,24]. They perform well, both as diagnostic and risk stratification tools, and are the best biomarkers currently available for myocardial infarction.…”

Section: Discussionmentioning

confidence: 99%

Serum Tryptase: A New Biomarker in Patients with Acute Coronary Syndrome?

Pastorello

Morici²,

Farioli³

et al. 2014

Int Arch Allergy Immunol

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Background: Mast cell tryptase has recently been reported to be involved in atherosclerotic plaque destabilization. However, the results of these reports are conflicting. Methods: The aim of this study was to characterize the role of tryptase as a prognostic marker of patient cardiovascular complexity in acute coronary syndrome (ACS). Furthermore, its association with an angiographic scoring system [defined by the SYNergy between percutaneous coronary intervention (PCI) with the TAXUS drug-eluting stent and the cardiac surgery (SYNTAX) score] was examined. The serum tryptase was measured at admission in 65 consecutive ACS patients and in 35 healthy controls. In the patients with ACS, a composite measure of clinical and angiographic patient cardiovascular complexity was indicated by two of the following: clinical adverse events at hospitalization, at least 2 epicardial coronary arteries involved in the atherosclerotic disease, more than 1 stent implanted or more than 2 coronary artery disease risk factors. Results: The tryptase measurements were lower in patients without the composite measure (p < 0.0005). Linear regression showed a significant relationship between tryptase levels and the SYNTAX score (SX-score). Conversely, high-sensitivity troponin values did not correlate with either the composite outcome or the SX-score. The predictive accuracy of serum tryptase for the composite outcome was set at the cut-off point of 5.22 ng/ml (sensitivity 81% and specificity 95.7%). Conclusion: In ACS patients, serum tryptase levels at admission may predict patient cardiovascular complexity more reliably than currently known biomarkers. Further studies are needed to demonstrate the long-term prognostic role of this biomarker in ACS.

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Section: Discussionmentioning

confidence: 99%

Serum Tryptase: A New Biomarker in Patients with Acute Coronary Syndrome?

Pastorello

Morici²,

Farioli³

et al. 2014

Int Arch Allergy Immunol

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“…The study cohort was enrolled in the Multiple Infarct Markers in Chest pain study, which was conducted at five EDs in Western Australia between September 2008 and June 2009. The methodology has been previously reported 10. In brief, patients undergoing serial troponin testing for evaluation of suspected ACS, as determined by the treating clinician, were eligible for recruitment.…”

Section: Methodsmentioning

confidence: 99%

Modified TIMI risk score cannot be used to identify low-risk chest pain in the emergency department: a multicentre validation study

et al. 2013

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“…Patients from the historical control group were sourced from the MIMIC database . All control participants were enrolled at the same hospital, risk stratified as intermediate risk for ACS and discharged from the ED.…”

Section: Methodsmentioning

confidence: 99%

Improving stress testing compliance following chest pain presentations to the emergency department

Chung

Playford

Macdonald

2012

Emerg Medicine Australasia

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Serial multiple biomarkers in the assessment of suspected acute coronary syndrome: multiple infarct markers in chest pain (MIMIC) study

Abstract: SMB alone is not sufficiently sensitive to exclude MI. Combined with risk scoring, SMB appears to identify patients at lower risk. This requires prospective validation.

Cited by 9 publications

References 29 publications

Serum Tryptase: A New Biomarker in Patients with Acute Coronary Syndrome?

Serum Tryptase: A New Biomarker in Patients with Acute Coronary Syndrome?

Modified TIMI risk score cannot be used to identify low-risk chest pain in the emergency department: a multicentre validation study

Improving stress testing compliance following chest pain presentations to the emergency department

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