Evidence mapPaperPMID 34727211Full record

ArticleClinical research in cardiology : official journal of the German Cardiac Society2022

The differential diagnostic value of selected cardiovascular biomarkers in Takotsubo syndrome.

Albert Topf, Moritz Mirna, Vera Paar, Lukas J Motloch, Janine Grueninger, Christiane Dienhart, Paul C Schulze, Mathias C Brandt, Robert Larbig, Uta C Hoppe and 2 more

Erratum issuedOpen access · hybridAbstract readEvaluation Study
In one paragraph

Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 pooled it
1.7field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 14 citations in OpenAlex.

  1. Pooled it
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors at 3 institutions in 2 countries.

Albert TopfClinic for Internal Medicine II, Department of Internal Medicine II, Paracelsus Medical University, University Hospital Salzburg, Paracelsus University Salzburg, Müllner Hauptstraße 48, 5020, Salzburg, Austria. albert.topf@hotmail.com.ORCID http://orcid.org/0000-0003-1211-4155
Moritz MirnaClinic for Internal Medicine II, Department of Internal Medicine II, Paracelsus Medical University, University Hospital Salzburg, Paracelsus University Salzburg, Müllner Hauptstraße 48, 5020, Salzburg, Austria.
Vera PaarClinic for Internal Medicine II, Department of Internal Medicine II, Paracelsus Medical University, University Hospital Salzburg, Paracelsus University Salzburg, Müllner Hauptstraße 48, 5020, Salzburg, Austria.
Lukas J MotlochClinic for Internal Medicine II, Department of Internal Medicine II, Paracelsus Medical University, University Hospital Salzburg, Paracelsus University Salzburg, Müllner Hauptstraße 48, 5020, Salzburg, Austria.
Janine GrueningerClinic for Internal Medicine II, Department of Internal Medicine II, Paracelsus Medical University, University Hospital Salzburg, Paracelsus University Salzburg, Müllner Hauptstraße 48, 5020, Salzburg, Austria.
Christiane DienhartDepartment of Internal Medicine I, Paracelsus Medical University, 5020, Salzburg, Austria.
Paul C SchulzeDivision of Cardiology, Department of Internal Medicine I, University Hospital Jena, 07743, Jena, Germany.
Mathias C BrandtClinic for Internal Medicine II, Department of Internal Medicine II, Paracelsus Medical University, University Hospital Salzburg, Paracelsus University Salzburg, Müllner Hauptstraße 48, 5020, Salzburg, Austria.
Robert LarbigDevision of Cardiology, Hospital Maria Hilf Moenchengladbach, 41063, Möenchengladbach, Germany.
Uta C HoppeClinic for Internal Medicine II, Department of Internal Medicine II, Paracelsus Medical University, University Hospital Salzburg, Paracelsus University Salzburg, Müllner Hauptstraße 48, 5020, Salzburg, Austria.
Daniel KretzschmarDivision of Cardiology, Department of Internal Medicine I, University Hospital Jena, 07743, Jena, Germany.
Michael LichtenauerClinic for Internal Medicine II, Department of Internal Medicine II, Paracelsus Medical University, University Hospital Salzburg, Paracelsus University Salzburg, Müllner Hauptstraße 48, 5020, Salzburg, Austria.
Paracelsus Medical University · ATJena University Hospital · DEKliniken Maria Hilf · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionTakotsubo syndrome (TTS) is clinically indistinguishable from an acute coronary syndrome (ACS). In the absence of valid markers for differential diagnosis, coronary angiography has been indispensable.

methodsIn our study, we evaluated the serum levels of sST-2, GDF-15, suPAR and H-FABP in 92 patients with the suspicion of TTS (51 TTS and 41 ACS patients) and 40 gender matched controls (no coronary artery disease or signs of heart failure) at baseline.

resultsH-FABP was significantly higher in ACS patients compared to TTS patients. Even in in propensity score matching for left ventricular ejection fraction, sex and cardiovascular risk factors, differences in the plasma levels of H-FABP in the matched cohort of TTS vs ACS remained statistically significant. Whereas, sST-2 was significantly elevated in TTS patients. H-FABP was superior for prediction of an ACS with even higher accuracy than hs troponin in differential diagnosis (AUC 0.797, p ≤ 0.0001); the optimal cut off for discrimination towards a TTS was calculated as 2.93 ng/ml (sensitivity 70.0%, specificity 82.4%, PPV 75.7%, NPV 77.4%). sST-2 seemed most appropriate for identification of a TTS (AUC 0.653, p = 0.012). The optimal cut off for differential diagnosis was 11018.06 pg/ml (sensitivity 82.0%, specificity 51.2%, PPV 69.4%, NPV 71.9 %).

conclusionH-FABP and sST-2 are the most promising markers with better accuracy than preexisting biomarkers in differential diagnosis in our study and therefore, could be crucial for the guidance of treatment in patients with high bleeding risk, advanced renal failure or multimorbidity.

Indexed as

AgedArea Under CurveBiomarkersCase-Control StudiesDiagnosis, DifferentialFatty Acid Binding Protein 3FemaleHeart Disease Risk FactorsHeart Function TestsHumansInterleukin-1 Receptor-Like 1 ProteinMaleMiddle AgedPredictive Value of TestsPropensity ScoreStroke VolumeBiomarkersFABP3 protein, humanFatty Acid Binding Protein 3IL1RL1 protein, humanInterleukin-1 Receptor-Like 1 ProteinAcute coronary syndromeBiomarkersDifferential diagnosisTakotsubo cardiomyopathy

Identifiers

PMID34727211
PMCPMC8816755
OpenAlexW3208567841

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.