{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T12:44:33Z","timestamp":1773060273719,"version":"3.50.1"},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,3,4]],"date-time":"2019-03-04T00:00:00Z","timestamp":1551657600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01HL111033"],"award-info":[{"award-number":["R01HL111033"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2019,5]]},"abstract":"Abstract<\/jats:title>Objectives<\/jats:title>An estimated 1.2 million annual emergency department (ED<\/jats:styled-content>) visits for syncope\/near syncope occur in the United States. Cardiac biomarkers are frequently obtained during the ED<\/jats:styled-content> evaluation, but the prognostic value of index high\u2010sensitivity troponin (hscTnT) and natriuretic peptide (NT<\/jats:styled-content>\u2010proBNP<\/jats:styled-content>) are unclear. The objective of this study was to determine if hscTnT and NT<\/jats:styled-content>\u2010proBNP<\/jats:styled-content> drawn in the ED<\/jats:styled-content> are independently associated with 30\u2010day death\/serious cardiac outcomes in adult patients presenting with syncope.<\/jats:p><\/jats:sec>Methods<\/jats:title>A prespecified secondary analysis of a prospective, observational trial enrolling participants \u2265 age 60 presenting with syncope, at 11 United States hospitals, was conducted between April 2013 and September 2016. Exclusions included seizure, stroke, transient ischemic attack, trauma, intoxication, hypoglycemia, persistent confusion, mechanical\/electrical invention, prior enrollment, or predicted poor follow\u2010up. Within 3 hours of consent, hscTnT and NT<\/jats:styled-content>\u2010proBNP<\/jats:styled-content> were collected and later analyzed centrally using Roche Elecsys Gen 5 STAT<\/jats:styled-content> and 2010 Cobas, respectively. Primary outcome was combined 30\u2010day all\u2010cause mortality and serious cardiac events. Adjusting for illness severity, using multivariate logistic regression analysis, variations between primary outcome and biomarkers were estimated, adjusting absolute risk associated with ranges of biomarkers using Bayesian Markov Chain Monte Carlo methods.<\/jats:p><\/jats:sec>Results<\/jats:title>The cohort included 3,392 patients; 367 (10.8%) experienced the primary outcome. Adjusted absolute risk for the primary outcome increased with hscTnT and NT<\/jats:styled-content>\u2010proBNP<\/jats:styled-content> levels. HscTnT levels \u2264 5 ng\/L were associated with a 4% (95% confidence interval [CI<\/jats:styled-content>] = 3%\u20135%) outcome risk, and hscTnT > 50 ng\/L, a 29% (95% CI<\/jats:styled-content> = 26%\u201333%) risk. NT<\/jats:styled-content>\u2010proBNP<\/jats:styled-content> levels \u2264 125 ng\/L were associated with a 4% (95% CI<\/jats:styled-content> = 4%\u20135%) risk, and NT<\/jats:styled-content>\u2010proBNP<\/jats:styled-content> > 2,000 ng\/L a 29% (95% CI<\/jats:styled-content> = 25%\u201332%) risk. Likelihood ratios and predictive values demonstrated similar results. Sensitivity analyses excluding ED<\/jats:styled-content> index serious outcomes demonstrated similar findings.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>hscTnT and NT<\/jats:styled-content>\u2010proBNP<\/jats:styled-content> are independent predictors of 30\u2010day death and serious outcomes in older ED<\/jats:styled-content> patients presenting with syncope.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.13709","type":"journal-article","created":{"date-parts":[[2019,2,5]],"date-time":"2019-02-05T20:36:22Z","timestamp":1549398982000},"page":"528-538","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Do High\u2010sensitivity Troponin and Natriuretic Peptide Predict Death or Serious Cardiac Outcomes After Syncope?"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0451-5960","authenticated-orcid":false,"given":"Carol 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