Diagnostic performance and optimal cut-off values of cardiac biomarkers for predicting cardiac injury in carbon monoxide poisoning
Objective This study aimed to compare the diagnostic performance of cardiac biomarkers and to evaluate the optimal cut-off values for echocardiographic cardiac injury prediction in patients with carbon monoxide (CO) poisoning. Methods This retrospective observational cohort study included adult pati...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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The Korean Society of Emergency Medicine
2020-09-01
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| Series: | Clinical and Experimental Emergency Medicine |
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| Online Access: | http://ceemjournal.org/upload/pdf/ceem-19-072.pdf |
| _version_ | 1797897170827870208 |
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| author | Jun Hwan Park Ran Heo Hyunggoo Kang Jaehoon Oh Tae Ho Lim Byuk Sung Ko |
| author_facet | Jun Hwan Park Ran Heo Hyunggoo Kang Jaehoon Oh Tae Ho Lim Byuk Sung Ko |
| author_sort | Jun Hwan Park |
| collection | DOAJ |
| description | Objective This study aimed to compare the diagnostic performance of cardiac biomarkers and to evaluate the optimal cut-off values for echocardiographic cardiac injury prediction in patients with carbon monoxide (CO) poisoning. Methods This retrospective observational cohort study included adult patients with acute CO poisoning. Patients who did not undergo transthoracic echocardiography, which was used to define patients with cardiac injury (ejection fraction <55%), were excluded. The area under the curve was used to evaluate diagnostic performance for cardiac injury prediction. Mann-Whitney U, chi-square, and Fisher exact tests were used to analyze data. Results After excluding the 27 patients who did not undergo echocardiography, 114 patients were included in the study. Fifteen (13.2%) patients had cardiac injury. The area under the curve values for the B-type natriuretic peptide, creatine kinase-myocardial band, and troponin I were 0.711 (95% confidence interval [CI], 0.527–0.895; P=0.011), 0.766 (95% CI, 0.607–0.926; P=0.001), and 0.801 (95% CI, 0.647–0.955; P<0.001), respectively, with optimal cut-off values of 330 pg/mL, 10.1 ng/mL, and 0.455 ng/mL, respectively. The sensitivity, specificity, and positive and negative predictive values of troponin I were 67%, 91%, 53%, and 95%, respectively. Conclusion Troponin I showed the best diagnostic performance for predicting cardiac injury in patients with CO poisoning. A cut-off value of 0.455 ng/mL appeared optimal for cardiac injury prediction. However, further studies on cardiac biomarkers and other diagnostic tools in CO poisoning are needed given the low sensitivity of troponin I. |
| first_indexed | 2024-04-10T07:54:26Z |
| format | Article |
| id | doaj.art-a1a6843d47b4485b9c78174f7be388d3 |
| institution | Directory Open Access Journal |
| issn | 2383-4625 |
| language | English |
| last_indexed | 2024-04-10T07:54:26Z |
| publishDate | 2020-09-01 |
| publisher | The Korean Society of Emergency Medicine |
| record_format | Article |
| series | Clinical and Experimental Emergency Medicine |
| spelling | doaj.art-a1a6843d47b4485b9c78174f7be388d32023-02-23T06:55:59ZengThe Korean Society of Emergency MedicineClinical and Experimental Emergency Medicine2383-46252020-09-017318318910.15441/ceem.19.072289Diagnostic performance and optimal cut-off values of cardiac biomarkers for predicting cardiac injury in carbon monoxide poisoningJun Hwan Park0Ran Heo1Hyunggoo Kang2Jaehoon Oh3Tae Ho Lim4Byuk Sung Ko5 Department of Emergency Medicine, Hanyang University College of Medicine, Seoul, Korea Division of Cardiology, Department of Internal Medicine, Hanyang University Medical Center, Seoul, Korea Department of Emergency Medicine, Hanyang University College of Medicine, Seoul, Korea Department of Emergency Medicine, Hanyang University College of Medicine, Seoul, Korea Department of Emergency Medicine, Hanyang University College of Medicine, Seoul, Korea Department of Emergency Medicine, Hanyang University College of Medicine, Seoul, KoreaObjective This study aimed to compare the diagnostic performance of cardiac biomarkers and to evaluate the optimal cut-off values for echocardiographic cardiac injury prediction in patients with carbon monoxide (CO) poisoning. Methods This retrospective observational cohort study included adult patients with acute CO poisoning. Patients who did not undergo transthoracic echocardiography, which was used to define patients with cardiac injury (ejection fraction <55%), were excluded. The area under the curve was used to evaluate diagnostic performance for cardiac injury prediction. Mann-Whitney U, chi-square, and Fisher exact tests were used to analyze data. Results After excluding the 27 patients who did not undergo echocardiography, 114 patients were included in the study. Fifteen (13.2%) patients had cardiac injury. The area under the curve values for the B-type natriuretic peptide, creatine kinase-myocardial band, and troponin I were 0.711 (95% confidence interval [CI], 0.527–0.895; P=0.011), 0.766 (95% CI, 0.607–0.926; P=0.001), and 0.801 (95% CI, 0.647–0.955; P<0.001), respectively, with optimal cut-off values of 330 pg/mL, 10.1 ng/mL, and 0.455 ng/mL, respectively. The sensitivity, specificity, and positive and negative predictive values of troponin I were 67%, 91%, 53%, and 95%, respectively. Conclusion Troponin I showed the best diagnostic performance for predicting cardiac injury in patients with CO poisoning. A cut-off value of 0.455 ng/mL appeared optimal for cardiac injury prediction. However, further studies on cardiac biomarkers and other diagnostic tools in CO poisoning are needed given the low sensitivity of troponin I.http://ceemjournal.org/upload/pdf/ceem-19-072.pdfcarbon monoxidepoisoningechocardiography |
| spellingShingle | Jun Hwan Park Ran Heo Hyunggoo Kang Jaehoon Oh Tae Ho Lim Byuk Sung Ko Diagnostic performance and optimal cut-off values of cardiac biomarkers for predicting cardiac injury in carbon monoxide poisoning Clinical and Experimental Emergency Medicine carbon monoxide poisoning echocardiography |
| title | Diagnostic performance and optimal cut-off values of cardiac biomarkers for predicting cardiac injury in carbon monoxide poisoning |
| title_full | Diagnostic performance and optimal cut-off values of cardiac biomarkers for predicting cardiac injury in carbon monoxide poisoning |
| title_fullStr | Diagnostic performance and optimal cut-off values of cardiac biomarkers for predicting cardiac injury in carbon monoxide poisoning |
| title_full_unstemmed | Diagnostic performance and optimal cut-off values of cardiac biomarkers for predicting cardiac injury in carbon monoxide poisoning |
| title_short | Diagnostic performance and optimal cut-off values of cardiac biomarkers for predicting cardiac injury in carbon monoxide poisoning |
| title_sort | diagnostic performance and optimal cut off values of cardiac biomarkers for predicting cardiac injury in carbon monoxide poisoning |
| topic | carbon monoxide poisoning echocardiography |
| url | http://ceemjournal.org/upload/pdf/ceem-19-072.pdf |
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