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Diagnostic and prognostic value of high-sensitivity cardiac troponin T in patients with syncope

Christ M, Geier F, Popp S, Singler K, Smolarsky A, Bertsch T, Mueller C, Greve Y (2015)

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Publication Type: Journal article

Publication year: 2015

Journal

Book Volume: 128

Pages Range: 161-170.e1

Journal Issue: 2

DOI: 10.1016/j.amjmed.2014.09.021

Abstract

We examined the diagnostic and predictive value of high-sensitivity cardiac troponin T (cTnThs) in patients with syncope.We performed an analysis of consecutive patients with syncope presenting to the emergency department. The primary end point was the accuracy to diagnose a cardiac syncope. In addition, the study explored the prognostic relevance of cTnThs in patients with cardiac and noncardiac syncope.A total of 360 patients were enrolled (median age, 70.5 years; male, 55.8%; 23.9% aged >80 years). Cardiac syncope was present in 22% of patients, reflex syncope was present in 40% of patients, syncope due to orthostatic hypotension was present in 20% of patients, and unexplained syncope was present in 17.5% of patients. A total of 148 patients (41%) had cTnThs levels above the 99% confidence interval (CI) (cutoff point). The diagnostic accuracy for cTnThs levels to determine the diagnosis of cardiac syncope was quantified by the area under the curve (0.77; CI, 0.72-0.83; P < .001). A comparable area under the curve (0.78; CI, 0.73-0.83; P < .001) was obtained for the predictive value of cTnThs levels within 30 days: Patients with increased cTnThs levels had a 52% likelihood for adverse events, patients with cTnThs levels below the cutoff point had a low risk (negative predictive value, 83.5%). Increased cTnThs levels indicate adverse prognosis in patients with noncardiac causes of syncope, but not in patients with cardiac syncope being a risk factor for adverse outcome by itself.Patients with syncope presenting to the emergency department have a high proportion of life-threatening conditions. cTnThs levels show a limited diagnostic and predictive accuracy for the identification of patients with syncope at high risk.

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How to cite

APA:

Christ, M., Geier, F., Popp, S., Singler, K., Smolarsky, A., Bertsch, T.,... Greve, Y. (2015). Diagnostic and prognostic value of high-sensitivity cardiac troponin T in patients with syncope. American Journal of Medicine, 128(2), 161-170.e1. https://doi.org/10.1016/j.amjmed.2014.09.021

MLA:

Christ, Michael, et al. "Diagnostic and prognostic value of high-sensitivity cardiac troponin T in patients with syncope." American Journal of Medicine 128.2 (2015): 161-170.e1.

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