Diagnostic value of the cardiac electrical biomarker, a novel ECG marker indicating myocardial injury, in patients with symptoms suggestive of non-ST-elevation myocardial infarction.

Strebel, Ivo; Twerenbold, Raphael; Boeddinghaus, Jasper; Abächerli, Roger; Rubini Giménez, Maria; Wildi, Karin; Grimm, Karin; Puelacher, Christian; Badertscher, Patrick; Sabti, Zaid; Breitenbücher, Dominik; Jann, Janina; Selman, Farah; du Fay de Lavallaz, Jeanne; Schaerli, Nicolas; Nestelberger, Thomas; Stelzig, Claudia; Freese, Michael; Schumacher, Lukas; Osswald, Stefan; ... (2018). Diagnostic value of the cardiac electrical biomarker, a novel ECG marker indicating myocardial injury, in patients with symptoms suggestive of non-ST-elevation myocardial infarction. Annals of noninvasive electrocardiology, 23(4), e12538. Wiley 10.1111/anec.12538

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BACKGROUND The cardiac electrical biomarker (CEB) is a novel electrocardiographic (ECG) marker quantifying the dipolar activity of the heart with higher levels indicating myocardial injury. METHODS We prospectively enrolled 1097 patients presenting with suspected non-ST-elevation myocardial infarction (NSTEMI) to the emergency department (ED). Digital 12-lead ECGs were recorded at presentation and the CEB values were calculated in a blinded fashion. The final diagnosis was adjudicated by two independent cardiologists. The prognostic endpoint was all-cause mortality during 2 years of follow-up. RESULTS NSTEMI was the final diagnosis in 14% of patients. CEB levels were higher in patients with NSTEMI compared to other causes of chest pain (median 44 (IQR 21-98) vs. 30 (IQR 16-61), p < .001). A weak but significant correlation between levels of high-sensitivity cardiac troponin T (hs-cTnT) at admission to the ED and the CEB was found (r = .23, p < .001). The use of the CEB in addition to conventional ECG criteria improved the diagnostic accuracy for the diagnosis of NSTEMI as quantified by the area under the receiver operating characteristics curve from 0.66 to 0.71 (p < .001) and the sensitivity improved from 43% to 79% (p < .001). CONCLUSION In conclusion, the CEB, an ECG marker of myocardial injury, significantly improves the accuracy and sensitivity of the ECG for the diagnosis of NSTEMI.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Reichlin, Tobias Roman

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1082-720X

Publisher:

Wiley

Language:

English

Submitter:

Tobias Roman Reichlin

Date Deposited:

19 Mar 2019 16:33

Last Modified:

23 Oct 2019 04:46

Publisher DOI:

10.1111/anec.12538

PubMed ID:

29476571

Uncontrolled Keywords:

clinical, electrocardiography epidemiology/clinical trials myocardial infarction noninvasive techniques

BORIS DOI:

10.7892/boris.126345

URI:

https://boris.unibe.ch/id/eprint/126345

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