Establishment of a nomogram model for acute chest pain triage in the chest pain center
BackgroundAcute myocardial infarction (AMI) is the leading life-threatening disease in the emergency department (ED), so rapid chest pain triage is important. This study aimed to establish a clinical prediction model for the risk stratification of acute chest pain patients based on the Point-of-care...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-03-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2023.930839/full |
| _version_ | 1797866896122445824 |
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| author | Na Yan Ling Wei Ling Wei Zhiwei Li Yu Song Yu Song |
| author_facet | Na Yan Ling Wei Ling Wei Zhiwei Li Yu Song Yu Song |
| author_sort | Na Yan |
| collection | DOAJ |
| description | BackgroundAcute myocardial infarction (AMI) is the leading life-threatening disease in the emergency department (ED), so rapid chest pain triage is important. This study aimed to establish a clinical prediction model for the risk stratification of acute chest pain patients based on the Point-of-care (POC) cardiac troponin (cTn) level and other clinical variables.MethodsWe conducted a post-hoc analysis of the database from 6,019 consecutive patients (excluding prehospital-diagnosed non-cardiac chest pain patients) attending a local chest pain center (CPC) in China between October 2016 and January 2019. The plasma concentration of cardiac troponin I (cTnI) was measured using a POC cTnI (Cardio Triage, Alere) assay. All the eligible patients were randomly divided into training and validation cohorts by a 7:3 ratio. We performed multivariable logistic regression to select variables and build a nomogram based on the significant predictive factors. We evaluated the model's generalization ability of diagnostic accuracy in the validation cohort.ResultsWe analyzed data from 5,397 patients that were included in this research. The median turnaround time (TAT) of POC cTnI was 16 min. The model was constructed with 6 variables: ECG ischemia, POC cTnI level, hypotension, chest pain symptom, Killip class, and sex. The area under the ROC curve (AUC) in the training and validation cohorts was 0.924 and 0.894, respectively. The diagnostic performance was superior to the GRACE score (AUC: 0.737).ConclusionA practical predictive model was created and could be used for rapid and effective triage of acute chest pain patients in the CPC. |
| first_indexed | 2024-04-09T23:31:38Z |
| format | Article |
| id | doaj.art-3f31c04607b648189f2a7d85e5019107 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-09T23:31:38Z |
| publishDate | 2023-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-3f31c04607b648189f2a7d85e50191072023-03-21T04:28:17ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-03-011010.3389/fcvm.2023.930839930839Establishment of a nomogram model for acute chest pain triage in the chest pain centerNa Yan0Ling Wei1Ling Wei2Zhiwei Li3Yu Song4Yu Song5Department of Emergency, TEDA International Cardiovascular Hospital, Clinical School of Cardiovascular Disease, Tianjin Medical University, Tianjin, ChinaDepartment of Emergency, TEDA International Cardiovascular Hospital, Clinical School of Cardiovascular Disease, Tianjin Medical University, Tianjin, ChinaDepartment of Emergency, TEDA Hospital, Tianjin, ChinaDepartment of Pathophysiology, State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, ChinaDepartment of Emergency, TEDA International Cardiovascular Hospital, Clinical School of Cardiovascular Disease, Tianjin Medical University, Tianjin, ChinaDepartment of Emergency, TEDA Hospital, Tianjin, ChinaBackgroundAcute myocardial infarction (AMI) is the leading life-threatening disease in the emergency department (ED), so rapid chest pain triage is important. This study aimed to establish a clinical prediction model for the risk stratification of acute chest pain patients based on the Point-of-care (POC) cardiac troponin (cTn) level and other clinical variables.MethodsWe conducted a post-hoc analysis of the database from 6,019 consecutive patients (excluding prehospital-diagnosed non-cardiac chest pain patients) attending a local chest pain center (CPC) in China between October 2016 and January 2019. The plasma concentration of cardiac troponin I (cTnI) was measured using a POC cTnI (Cardio Triage, Alere) assay. All the eligible patients were randomly divided into training and validation cohorts by a 7:3 ratio. We performed multivariable logistic regression to select variables and build a nomogram based on the significant predictive factors. We evaluated the model's generalization ability of diagnostic accuracy in the validation cohort.ResultsWe analyzed data from 5,397 patients that were included in this research. The median turnaround time (TAT) of POC cTnI was 16 min. The model was constructed with 6 variables: ECG ischemia, POC cTnI level, hypotension, chest pain symptom, Killip class, and sex. The area under the ROC curve (AUC) in the training and validation cohorts was 0.924 and 0.894, respectively. The diagnostic performance was superior to the GRACE score (AUC: 0.737).ConclusionA practical predictive model was created and could be used for rapid and effective triage of acute chest pain patients in the CPC.https://www.frontiersin.org/articles/10.3389/fcvm.2023.930839/fullacute chest pain triageacute myocardial infarctiontroponinpoint-of-care (POC)acute coronary syndrome |
| spellingShingle | Na Yan Ling Wei Ling Wei Zhiwei Li Yu Song Yu Song Establishment of a nomogram model for acute chest pain triage in the chest pain center Frontiers in Cardiovascular Medicine acute chest pain triage acute myocardial infarction troponin point-of-care (POC) acute coronary syndrome |
| title | Establishment of a nomogram model for acute chest pain triage in the chest pain center |
| title_full | Establishment of a nomogram model for acute chest pain triage in the chest pain center |
| title_fullStr | Establishment of a nomogram model for acute chest pain triage in the chest pain center |
| title_full_unstemmed | Establishment of a nomogram model for acute chest pain triage in the chest pain center |
| title_short | Establishment of a nomogram model for acute chest pain triage in the chest pain center |
| title_sort | establishment of a nomogram model for acute chest pain triage in the chest pain center |
| topic | acute chest pain triage acute myocardial infarction troponin point-of-care (POC) acute coronary syndrome |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2023.930839/full |
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