{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T20:11:45Z","timestamp":1780344705935,"version":"3.54.1"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T00:00:00Z","timestamp":1678752000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001711","name":"Swiss National Science Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Swiss Heart Foundation"},{"name":"KTI"},{"DOI":"10.13039\/501100000780","name":"European Union","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100008375","name":"University of Basel","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100008375","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100016015","name":"University Hospital Basel","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100016015","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Abbott"},{"name":"Beckman Coulter"},{"name":"Biomerieux"},{"DOI":"10.13039\/501100016198","name":"Idorsia","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100016198","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Ortho Cinical Diagnostics"},{"name":"Quidel"},{"name":"Roche"},{"name":"Siemens"},{"DOI":"10.13039\/100016946","name":"Singulex","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":[[2023,5,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>The presence of accompanying dyspnoea is routinely assessed and common in patients presenting with acute chest pain\/discomfort to the emergency department (ED). We aimed to assess the association of accompanying dyspnoea with differential diagnoses, diagnostic work-up, and outcome.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>We enrolled patients presenting to the ED with chest pain\/discomfort. Final diagnoses were adjudicated by independent cardiologists using all information including cardiac imaging. The primary diagnostic endpoint was the final diagnosis. The secondary diagnostic endpoint was the performance of high-sensitivity cardiac troponin (hs-cTn) and the European Society of Cardiology (ESC) 0\/1h-algorithms for the diagnosis of myocardial infarction (MI). The prognostic endpoints were cardiovascular and all-cause mortality at two years. Among 6045 patients, 2892\/6045 (48%) had accompanying dyspnoea. The prevalence of acute coronary syndrome (ACS) in patients with vs. without dyspnoea was comparable (MI 22.4% vs. 21.9%, P = 0.60, unstable angina 8.7% vs. 7.9%, P = 0.29). In contrast, patients with dyspnoea more often had cardiac, non-coronary disease (15.3% vs. 10.2%, P &amp;lt; 0.001). Diagnostic accuracy of hs-cTnT\/I concentrations was not affected by the presence of dyspnoea (area under the curve 0.89\u20130.91 in both groups), and the safety of the ESC 0\/1h-algorithms was maintained with negative predictive values &amp;gt;99.4%. Accompanying dyspnoea was an independent predictor for cardiovascular and all-cause death at two years [hazard ratio 1.813 (95% confidence intervals, 1.453\u20132.261, P &amp;lt; 0.01)].<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Accompanying dyspnoea was not associated with a higher prevalence of ACS but with cardiac, non-coronary disease. While the safety of the diagnostic work-up was not affected, accompanying dyspnoea was an independent predictor for cardiovascular and all-cause death.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Trial Registration<\/jats:title>\n                  <jats:p>https:\/\/clinicaltrials.gov\/ct2\/show\/NCT00470587, number NCT00470587<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjacc\/zuad026","type":"journal-article","created":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T18:36:41Z","timestamp":1678819001000},"page":"283-295","source":"Crossref","is-referenced-by-count":5,"title":["Association of accompanying dyspnoea with diagnosis and outcome of patients presenting with acute chest discomfort"],"prefix":"10.1093","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4404-4956","authenticated-orcid":false,"given":"Jasper","family":"Boeddinghaus","sequence":"first","affiliation":[{"name":"Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel , Petersgraben 4, CH-4031 Basel , Switzerland"},{"name":"GREAT network , Rome , Italy"},{"name":"BHF Centre for Cardiovascular Science, University of Edinburgh , Scotland , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2173-5738","authenticated-orcid":false,"given":"Thomas","family":"Nestelberger","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel , Petersgraben 4, CH-4031 Basel , Switzerland"},{"name":"GREAT network , Rome , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2929-8600","authenticated-orcid":false,"given":"Luca","family":"Koechlin","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel , Petersgraben 4, CH-4031 Basel , Switzerland"},{"name":"GREAT network , Rome , Italy"},{"name":"Department of Cardiac Surgery, University Hospital Basel, University of Basel , Switzerland"}],"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":"Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel , Petersgraben 4, CH-4031 Basel , Switzerland"},{"name":"GREAT network , Rome , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1793-5297","authenticated-orcid":false,"given":"Desiree","family":"Wussler","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel , Petersgraben 4, CH-4031 Basel , Switzerland"},{"name":"GREAT network , Rome , Italy"},{"name":"Division of Internal Medicine, University Hospital Basel, University of Basel , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian","family":"Mais","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel , Petersgraben 4, CH-4031 Basel , 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Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivo","family":"Strebel","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel , Petersgraben 4, CH-4031 Basel , Switzerland"},{"name":"GREAT network , Rome , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d2scar","family":"Mir\u00f3","sequence":"additional","affiliation":[{"name":"GREAT network , Rome , Italy"},{"name":"Emergency Department, Hospital Clinic , Barcelona, Catalonia , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F Javier","family":"Martin-Sanchez","sequence":"additional","affiliation":[{"name":"GREAT network , Rome , Italy"},{"name":"Servicio de Urgencias, Hospital Cl\u00ednico San Carlos , Madrid , 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