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Identification of acute myocardial infarction in elderly patients using optimized highly sensitive troponin I thresholds |
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| Authors: | Beatrice von Jeinsen Christoph Liebetrau Lars Palapies Stergios Tzikas Tanja Zeller Christoph Bickel |
| Affiliation: | 1. Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany;2. Department of Internal Medicine III, Division of Cardiology, Goethe University Frankfurt, Frankfurt, Germany;3. German Centre for Cardiovascular Research (DZHK), Partner Site Center Rhein-Main, Germany;4. Department of Internal Medicine III, Division of Cardiology, Goethe University Frankfurt, Frankfurt, Germany;5. 3rd Department of Cardiology, ιppokrateio Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece;6. Clinic for General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany;7. German Centre for Cardiovascular Research (DZHK), German Partner Site Hamburg/Kiel/Lübeck partner, Hamburg, Germany;8. Department of Internal Medicine, Federal Armed Forces Hospital, Koblenz, Germany |
| Abstract: | Purpose: Established diagnostic thresholds for high-sensitivity cardiac troponins (hs-cTn) might not apply for elderly patients as they are elevated irrespective of the presence of an acute myocardial infarction (AMI). Aim of the present study was to investigate hs-cTnI in elderly patients with suspected AMI and to calculate optimized diagnostic cutoffs. Material and methods: Data from a prospective multi-centre study and from a second independent prospective single-centre cohort study were analysed. A number of 2903 patients were eligible for further analysis. Patients > 70 years were classified as elderly. hs-cTnI was measured upon admission. Results: Around 34.7% of 2903 patients were classified as elderly. Around 22.5% of elderly patients were finally diagnosed with AMI. Elderly patients had higher hs-cTnI levels at admission irrespective of the final diagnosis (p? Conclusions: hs-cTnI levels have a lower specificity for detecting AMI in elderly patients. This lower specificity can be improved by using hs-cTnI thresholds optimized for elderly patients. |
| Keywords: | Acute myocardial infarction troponin biomarkers elderly age |