Evidence map›Paper›PMID 39422200›Full record

Observational studyEuropean heart journal. Acute cardiovascular care2024

Novel troponin fragmentation assay to discriminate between Takotsubo syndrome and acute myocardial infarction.

Juhani K E Airaksinen, Tuulia Tuominen, Tuomas Paana, Tapio Hellman, Tuija Vasankari, Selma Salonen, Helea Junes, Anna Linko-Parvinen, Hanna-Mari Pallari, Marjatta Strandberg and 3 more

Registry-linked trialAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in European heart journal. Acute cardiovascular care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04465591 (Troponin T Fragmentation in the Assessment of Myocardial Injury Study), which is not on this map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
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.

NCT04465591 recruitingnot on this map

Troponin T Fragmentation in the Assessment of Myocardial Injury Study

Typeobservational_patient_registrySponsorUniversity of TurkuRan2020 to 2028Enrolled1,500ConditionsAcute Myocardial Infarction Type 1, Myocardial InjuryArmstroponin T fragmentation test
3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Observational
  3. Article
  4. Review
  5. Review
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Juhani K E AiraksinenHeart Center, Turku University Hospital, University of Turku, Hämeentie 11, PO Box 52, 20521 Turku, Finland.ORCID 0000-0002-0193-568X
Tuulia TuominenBiotechnology Unit, Department of Life technologies, University of Turku, Turku, Finland.
Tuomas PaanaHeart Center, Turku University Hospital, University of Turku, Hämeentie 11, PO Box 52, 20521 Turku, Finland.ORCID 0000-0002-7441-0278
Tapio HellmanKidney Center, Turku University Hospital, University of Turku, Turku, Finland.ORCID 0000-0001-9453-5687
Tuija VasankariHeart Center, Turku University Hospital, University of Turku, Hämeentie 11, PO Box 52, 20521 Turku, Finland.
Selma SalonenBiotechnology Unit, Department of Life technologies, University of Turku, Turku, Finland.
Helea JunesBiotechnology Unit, Department of Life technologies, University of Turku, Turku, Finland.
Anna Linko-ParvinenTYKS Laboratories, Clinical Chemistry, Turku University Hospital, Turku, Finland.
Hanna-Mari PallariTYKS Laboratories, Clinical Chemistry, Turku University Hospital, Turku, Finland.
Marjatta StrandbergEmergency Care, Turku University Hospital, Turku, Finland.
Konsta TeppoHeart Center, Turku University Hospital, University of Turku, Hämeentie 11, PO Box 52, 20521 Turku, Finland.ORCID 0000-0002-4460-0994
Samuli JaakkolaHeart Center, Turku University Hospital, University of Turku, Hämeentie 11, PO Box 52, 20521 Turku, Finland.
Saara WittfoothBiotechnology Unit, Department of Life technologies, University of Turku, Turku, Finland.ORCID 0000-0002-7886-3477

Funding

Business FinlandClinical Research FundFinnish Cultural FoundationFinnish Foundation for Cardiovascular ResearchFinnish Society of Clinical ChemistryTurku University FoundationTurku University HospitalVarsinais-Suomi Regional Fund
6 · The paper itself

Abstract

aimsCardiac troponin levels are elevated in Takotsubo syndrome (TTS) with significant overlap to acute myocardial infarction (MI). Long and intact cardiac troponin T (cTnT) forms are typical for MI. This study sought to assess whether the fragmentation composition of cTnT release in TTS differs from MI. METHODS AND

resultsThe concentration of long molecular forms of cTnT (long cTnT) was measured with a novel upconversion luminescence immunoassay and total cTnT with a commercial high-sensitivity cTnT assay in 24 TTS patients and in 84 Type 1 MI patients. The ratio of long to total cTnT (troponin ratio) was determined as a measure of cTnT fragmentation. Troponin ratio was lower in TTS patients [0.13 (0.10-0.20) vs. 0.62 (0.29-0.96), P < 0.001]. In the receiver operating characteristic curve analyses, troponin ratio showed a better predictive power than total cTnT in discriminating TTS and MI patients {area under the curve [AUC] 0.869 [95% confidence interval (CI) 0.789-0.948] vs. 0.766 [95% CI 0.677-0.855], P = 0.047}. When restricting the analysis to patients with total cTnT below 1200 ng/L (maximal value in TTS patients), the respective AUC values for total cTnT and troponin ratio were 0.599 (95% CI 0.465-0.732) and 0.816 (95% CI 0.712-0.921) (P = 0.003). At a cut-off point of 0.12, troponin ratio correctly identified 95% of MI patients and 50% of TTS patients.

conclusionIn contrast to Type 1 MI, only a small fraction of circulating cTnT in TTS exists in intact or long molecular forms. This clear difference in troponin composition could be of diagnostic value when evaluating patients with cTnT elevations and suspicion of TTS. CLINICAL

trial registrationURL: https://www.clinicaltrials.gov; Unique identifier: NCT04465591.

Indexed as

BiomarkersMyocardial InfarctionTakotsubo CardiomyopathyTroponin TAgedDiagnosis, DifferentialFemaleHumansMaleMiddle AgedROC CurveBiomarkersTroponin TBiomarkerMyocardial infarctionMyocardial injuryTakotsubo syndromeTroponin

Identifiers

PMID39422200
PMCPMC11638851

What Socratic holds

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Registered trials

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.