Early diagnosis of acute coronary syndrome

Beitrag in einer Fachzeitschrift


Details zur Publikation

Autor(en): Katus H, Ziegler A, Ekinci O, Giannitsis E, Stough WG, Achenbach S, Blankenberg S, Brueckmann M, Collinson P, Comaniciu D, Crea F, Dinh W, Ducrocq G, Flachskampf FA, Fox KAA, Friedrich MG, Hebert KA, Himmelmann A, Hlatky M, Lautsch D, Lindahl B, Lindholm D, Mills NL, Minotti G, Moeckel M, Omland T, Semjonow V
Zeitschrift: European Heart Journal
Jahr der Veröffentlichung: 2017
Band: 38
Heftnummer: 41
Seitenbereich: 3049-3055
ISSN: 0195-668X


Abstract

The diagnostic evaluation of acute chest pain has been augmented in recent years by advances in the sensitivity and precision of cardiac troponin assays, new biomarkers, improvements in imaging modalities, and release of new clinical decision algorithms. This progress has enabled physicians to diagnose or rule-out acute myocardial infarction earlier after the initial patient presentation, usually in emergency department settings, which may facilitate prompt initiation of evidence-based treatments, investigation of alternative diagnoses for chest pain, or discharge, and permit better utilization of healthcare resources. A non-trivial proportion of patients fall in an indeterminate category according to rule-out algorithms, and minimal evidence-based guidance exists for the optimal evaluation, monitoring, and treatment of these patients. The Cardiovascular Round Table of the ESC proposes approaches for the optimal application of early strategies in clinical practice to improve patient care following the review of recent advances in the early diagnosis of acute coronary syndrome. The following specific 'indeterminate' patient categories were considered: (i) patients with symptoms and high-sensitivity cardiac troponin <99th percentile; (ii) patients with symptoms and high-sensitivity troponin <99th percentile but above the limit of detection; (iii) patients with symptoms and high-sensitivity troponin >99th percentile but without dynamic change; and (iv) patients with symptoms and high-sensitivity troponin >99th percentile and dynamic change but without coronary plaque rupture/erosion/dissection. Definitive evidence is currently lacking to manage these patients whose early diagnosis is 'indeterminate' and these areas of uncertainty should be assigned a high priority for research.


FAU-Autoren / FAU-Herausgeber

Achenbach, Stephan Prof. Dr. med.
Lehrstuhl für Innere Medizin II


Autor(en) der externen Einrichtung(en)
Akershus University Hospital / Akershus universitetssykehus (Ahus)
AstraZenaca R&D
Bayer HealthCare AG
Boehringer Ingelheim Pharma GmbH & Co. KG
Campbell University
Campus Bio-Medico University of Rome
Catholic University of the Sacred Heart / Università Cattolica del Sacro Cuore
Charité - Universitätsmedizin Berlin
GE Healthcare Sweden
Hôpital Bichat-Claude-Bernard (CHU, APHP)
McGill University
Merck Sharp & Dohme Corp
Philips Electronics Nederland BV
Roche Diagnostics GmbH
Ruprecht-Karls-Universität Heidelberg
Siemens AG, Healthcare Sector
Stanford University
St George's Hospital
Universitätsklinikum Hamburg-Eppendorf
University of Edinburgh
Uppsala University


Zitierweisen

APA:
Katus, H., Ziegler, A., Ekinci, O., Giannitsis, E., Stough, W.G., Achenbach, S.,... Semjonow, V. (2017). Early diagnosis of acute coronary syndrome. European Heart Journal, 38(41), 3049-3055. https://dx.doi.org/10.1093/eurheartj/ehx492

MLA:
Katus, Hugo, et al. "Early diagnosis of acute coronary syndrome." European Heart Journal 38.41 (2017): 3049-3055.

BibTeX: 

Zuletzt aktualisiert 2018-13-11 um 12:53