{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T16:35:11Z","timestamp":1787502911990,"version":"build-2736575974"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,1,13]],"date-time":"2022-01-13T00:00:00Z","timestamp":1642032000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004257","name":"Western Norway Regional Health Authority","doi-asserted-by":"publisher","award":["912265"],"award-info":[{"award-number":["912265"]}],"id":[{"id":"10.13039\/501100004257","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004257","name":"Western Norway Regional Health Authority","doi-asserted-by":"publisher","award":["F-12501"],"award-info":[{"award-number":["F-12501"]}],"id":[{"id":"10.13039\/501100004257","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001711","name":"Swiss National Science Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004362","name":"Swiss Heart Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004362","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000780","name":"European Union","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001808","name":"Kommission f\u00fcr Technologie und Innovation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001808","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008375","name":"University of Basel","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008375","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016015","name":"University Hospital Basel","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016015","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001316","name":"Abbott Laboratories","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001316","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Beckman Coulter"},{"name":"BRAHMS GmbH"},{"name":"Idorsia Pharmaceuticals Ltd"},{"name":"Quidel Corporation"},{"DOI":"10.13039\/100004337","name":"F.Hoffmann-La Roche AG","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100004337","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Siemens AG"},{"DOI":"10.13039\/100016946","name":"Singulex Inc","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100016946","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study tested the hypothesis that combining stress-induced biomarkers (copeptin or glucose) with high-sensitivity cardiac troponin (hs-cTn) increases diagnostic accuracy for non-ST-elevation myocardial infarction (NSTEMI) in patients presenting to the emergency department.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>The ability to rule-out NSTEMI for combinations of baseline hs-cTnT or hs-cTnI with copeptin or glucose was compared with the European Society of Cardiology (ESC) hs-cTnT\/I-only rule-out algorithms in two independent (one Norwegian and one international multicentre) diagnostic studies. Among 959 patients (median age 64\u2009years, 60.5% male) with suspected NSTEMI in the Norwegian cohort, 13% had NSTEMI. Adding copeptin or glucose to hs-cTnT\/I as a continuous variable did not improve discrimination as quantified by the area under the curve {e.g. hs-cTnT\/copeptin 0.91 [95% confidence interval (CI) 0.89\u20130.93] vs. hs-cTnT alone 0.91 (95% CI 0.89\u20130.93); hs-cTnI\/copeptin 0.85 (95% CI 0.82\u20130.87) vs. hs-cTnI alone 0.93 (95% CI 0.91\u20130.95)}, nor did adding copeptin &amp;lt;9\u2009mmol\/L or glucose &amp;lt;5.6\u2009mmol\/L increase the sensitivity of the rule-out provided by hs-cTnT &amp;lt;5\u2009ng\/L or hs-cTnI &amp;lt;4\u2009ng\/L in patients presenting more than 3\u2009h after chest pain onset (target population in the ESC-0\u2009h-algorithm). The combination decreased rule-out efficacy significantly (both P\u2009&amp;lt;\u20090.01). These findings were confirmed among 1272 patients (median age 62\u2009years, 69.3% male) with suspected NSTEMI in the international validation cohort, of which 20.7% had NSTEMI. A trend towards increased sensitivity for the hs-cTnT\/I\/copeptin combinations (97\u2013100% vs. 91\u201397% for the ESC-0\u2009h-rule-out cut-offs) was observed in the Norwegian cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Adding copeptin or glucose to hs-cTnT\/I did not increase diagnostic performance when compared with current ESC guideline hs-cTnT\/I-only 0\u2009h-algorithms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjacc\/zuab124","type":"journal-article","created":{"date-parts":[[2021,12,14]],"date-time":"2021-12-14T15:24:14Z","timestamp":1639495454000},"page":"201-212","source":"Crossref","is-referenced-by-count":8,"title":["Adding stress biomarkers to high-sensitivity cardiac troponin for rapid non-ST-elevation myocardial infarction rule-out protocols"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8922-7014","authenticated-orcid":false,"given":"Ingar Ziad","family":"Restan","sequence":"first","affiliation":[{"name":"Department of Cardiology, Stavanger University Hospital, Pb. 8100, 4068 Stavanger, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Yufera","family":"Sanchez","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland"},{"name":"Global research on acute conditions team, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2520-9436","authenticated-orcid":false,"given":"Ole-Thomas","family":"Steiro","sequence":"additional","affiliation":[{"name":"Department of Heart Disease, Haukeland University Hospital, Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7787-0640","authenticated-orcid":false,"given":"Pedro","family":"Lopez-Ayala","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland"},{"name":"Global research on acute conditions team, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2577-5497","authenticated-orcid":false,"given":"Hilde L","family":"Tjora","sequence":"additional","affiliation":[{"name":"Emergency Care Clinic, Haukeland University Hospital, Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3037-054X","authenticated-orcid":false,"given":"J\u00f8rund","family":"Lang\u00f8rgen","sequence":"additional","affiliation":[{"name":"Department of Heart Disease, Haukeland University Hospital, Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6452-0369","authenticated-orcid":false,"given":"Torbj\u00f8rn","family":"Omland","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Akershus University Hospital, Oslo, Norway"},{"name":"Center for Heart Failure Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasper","family":"Boeddinghaus","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland"},{"name":"Global research on acute conditions team, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2173-5738","authenticated-orcid":false,"given":"Thomas","family":"Nestelberger","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland"},{"name":"Global research on acute conditions team, Rome, Italy"},{"name":"Division of Cardiology, Department of Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2929-8600","authenticated-orcid":false,"given":"Luca","family":"Koechlin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland"},{"name":"Global research on acute conditions team, Rome, Italy"},{"name":"Department of Cardiac Surgery, University Hospital Basel, University of Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7000-5996","authenticated-orcid":false,"given":"Paul","family":"Collinson","sequence":"additional","affiliation":[{"name":"Cardiovascular Clinical Academic Group, Molecular and Clinical Sciences Research Institute, St. George's, University of London, London, UK"},{"name":"Clinical Blood Science, St George's University Hospitals NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6637-5743","authenticated-orcid":false,"given":"Rune","family":"Bj\u00f8rneklett","sequence":"additional","affiliation":[{"name":"Emergency Care Clinic, Haukeland University Hospital, Bergen, Norway"},{"name":"Department of Clinical Medicine, University of Bergen, Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4794-6269","authenticated-orcid":false,"given":"Kjell","family":"Vikenes","sequence":"additional","affiliation":[{"name":"Department of Heart Disease, Haukeland University Hospital, Bergen, Norway"},{"name":"Department of Clinical Science, University of Bergen, Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi","family":"Strand","sequence":"additional","affiliation":[{"name":"Multidisciplinary Laboratory Medicine and Medical Biochemistry, Akershus University Hospital, L\u00f8renskog, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d8yvind","family":"Skadberg","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Biochemistry, Stavanger University Hospital, Stavanger, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d8istein R","family":"Mjelva","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Stavanger University Hospital, Pb. 8100, 4068 Stavanger, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9141-0499","authenticated-orcid":false,"given":"Alf Inge","family":"Larsen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Stavanger University Hospital, Pb. 8100, 4068 Stavanger, Norway"},{"name":"Department of Clinical Science, University of Bergen, Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vernon V S","family":"Bonarjee","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Stavanger University Hospital, Pb. 8100, 4068 Stavanger, 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