{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T09:11:43Z","timestamp":1744189903131,"version":"3.37.3"},"reference-count":24,"publisher":"Wiley","license":[{"start":{"date-parts":[[2018,11,12]],"date-time":"2018-11-12T00:00:00Z","timestamp":1541980800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Disease Markers"],"published-print":{"date-parts":[[2018,11,12]]},"abstract":"<jats:p><jats:italic>Background.<\/jats:italic> Clinical short-term risk stratification is a recommended approach in patients with chest pain and possible acute myocardial infarction (AMI) to further improve high safety of biomarker-based rule-out algorithms. The study aim was to assess clinical performance of baseline concentrations of high-sensitivity cardiac troponin T (hs-TnT) and copeptin and the modified HEART score (mHS) in early presenters to the emergency department with chest pain. <jats:italic>Methods<\/jats:italic>. This cohort study included patients with chest pain with onset maximum of 6\u2009h before admission and no persistent ST-segment elevation on electrocardiogram. hs-TnT, copeptin, and the mHS were assessed from admission data. The diagnostic and prognostic value for three baseline rule-out algorithms: (1) single hs-TnT\u2009&lt;\u200914\u2009ng\/l, (2) hs-TnT\u2009&lt;\u200914\u2009ng\/l\/mHS\u2009\u2264\u20093, and (3) hs-TnT\u2009&lt;\u200914\u2009ng\/l\/mHS\u2009\u2264\u20093\/copeptin\u2009&lt;\u200917.4\u2009pmol\/l, was assessed with sensitivity and negative predictive value. Primary diagnostic endpoint was the diagnosis of AMI. Prognostic endpoint was death and\/or AMI within 30 days. <jats:italic>Results<\/jats:italic>. Among 154 enrolled patients, 44 (29%) were classified as low-risk according to the mHS; AMI was diagnosed in 105 patients (68%). For ruling out AMI, the highest sensitivity and NPV from all studied algorithms were observed for hs-TnT\/mHS\/copeptin (100%, 95% CI 96.6\u2013100, and 100%, 95% CI 75.3\u2013100). At 30 days, the highest event-free survival was achieved in patients stratified with hs-TnT\/mHS\/copeptin algorithm (100%) with 100% (95% CI 75.3\u2013100) NPV and 100% (95% CI 96.6\u2013100) sensitivity. <jats:italic>Conclusions<\/jats:italic>. The combination of baseline hs-TnT, copeptin, and the mHS has an excellent sensitivity and NPV for short-term risk stratification. Such approach might improve the triage system in emergency departments and be a bridge for inclusion to serial blood sampling algorithms.<\/jats:p>","DOI":"10.1155\/2018\/9136971","type":"journal-article","created":{"date-parts":[[2018,11,12]],"date-time":"2018-11-12T18:33:35Z","timestamp":1542047615000},"page":"1-7","source":"Crossref","is-referenced-by-count":5,"title":["Combined Use of High-Sensitive Cardiac Troponin, Copeptin, and the Modified HEART Score for Rapid Evaluation of Chest Pain Patients"],"prefix":"10.1155","volume":"2018","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0187-1364","authenticated-orcid":true,"given":"Beata","family":"Morawiec","sequence":"first","affiliation":[{"name":"2nd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brygida","family":"Przywara-Chowaniec","sequence":"additional","affiliation":[{"name":"2nd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piotr","family":"Muzyk","sequence":"additional","affiliation":[{"name":"2nd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariusz","family":"Opara","sequence":"additional","affiliation":[{"name":"2nd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lam","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine with Cardiology, Tuen Mun Hospital, Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lui Chun","family":"Tat","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine with Cardiology, Tuen Mun Hospital, Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivier","family":"Muller","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital (CHUV), Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ewa","family":"Nowalany-Kozielska","sequence":"additional","affiliation":[{"name":"2nd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Damian","family":"Kawecki","sequence":"additional","affiliation":[{"name":"2nd Department of Cardiology, School of Medicine with the Division of 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