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J u l y 2 3 - 2 4 , 2 0 1 8 | R o m e , I t a l y
allied
academies
Joint Event on
Cardiology Congress 2018 & Microbe Infection 2018
Biomedical Research
|
ISSN: 0976-1683
|
Volume 29
2
nd
World Congress on
CARDIOLOGY
MICROBIOLOGY AND MICROBIAL INFECTION
&
39
th
Annual Congress on
Marta Noemi Monari et al., Biomed Res 2018, Volume 29 | DOI: 10.4066/biomedicalresearch-C1-002
SHAH VS. BACKMAN VS. ABBOT’S CUT
OFF FOR HSTNL SHOWED DIFFERENT
POSSIBILITIES IN PATIENTS WITH CHEST
PAIN PROFILE?
Marta Noemi Monari
1
, L Motta
2
, A Molteni
2,3
, A Voza
4
, P Bianchi
1
,
F Maura
1
, Barbieri B
1
, M Pedretti
1
and
M F Rossi
1
1
Humanitas Clinical and Research Center, Italy
2
IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Italy
3
ASST Lecco, Italy
4
Humanitas University, Italy
Background:
Chest pain is a common cause of worldwide hospital admission
and is a major burden on health-care resources. Cardiac troponin has
substantially improved the accuracy of diagnosis and prognostic assessment
of patients with suspected acute coronary syndrome (ACS). We wanted to
investigate the use of a high sensitive assays for cardiac troponin (hsTnl)
in the emergency department and its influence in patients admission or
discharge (according to assigned color code and pain during triage), in order
to identify the best one in terms of accuracy between the gap from the cut off
and the need of hospitalization.
Methods:
We have conducted a retrospective analysis based on 1758 (three
month) accessions in emergency department (ED). We have focused our
attention between 1014 patients (534 men, 480 women) having cardiological
profile, excluding thoracic trauma or other non cardiological pain. We
compared three different possible scenarios to ruled in chest pain patients to
intepretate the hsTnl: from literature Shah 12 ng/L, for Abbott hsTnl 34 ng/L
for men, 15 ng/L for woman; and Beckman Coulter hsTnl 19.8 ng/L for men
and 11.6 ng/L for woman.
Results:
The need of hospitalization was associated with a value above the
cut-off of each method taken into in a statistically significant way (Abbott,
p<0.001; Beckman, p<0.001; Shah, p<0.001). Moreover, the gap from the cut-
off is associated with an increased probability of admission, corrected for
age, gender and color code (Abbott OR 7.74, 95% CI 2.89-20.75, p<0.001;
Backman 3.93, 95% CI 1.89-8.18, p<0.001; Shah 5.06, 95% CI 2.51-10.22,
p<0.001). The hospitalization is highly associated with the color code
(p<0.001) given during the triage.
Conclusion:
In this population, there is not a statistically significant difference
between the three different interpretative cut off taken into consideration
in identifying hospitalized patients. There is a statistically significant
association between the color code given during the triage, the hsTnl level
and the hospitalization, so the real key of the use of this marker is strongly
related to the correct diagnosis.
Marta Noemi Monari is working in Humanitas clinical
and research center, Italy
marta_noemi.monari@humanitas.itBIOGRAPHY