Diagnostic value of the cardiac electrical biomarker, a novel ECG marker indicating myocardial injury, in patients with symptoms suggestive of non-ST-elevation myocardial infarction.

DOI
Publisher DOI
PubMed ID
29476571
Abstract
BACKGROUND

The cardiac electrical biomarker (CEB) is a novel electrocardiographic (ECG) marker quantifying the dipolar activity of the heart with higher levels indicating myocardial injury.

METHODS

We prospectively enrolled 1097 patients presenting with suspected non-ST-elevation myocardial infarction (NSTEMI) to the emergency department (ED). Digital 12-lead ECGs were recorded at presentation and the CEB values were calculated in a blinded fashion. The final diagnosis was adjudicated by two independent cardiologists. The prognostic endpoint was all-cause mortality during 2 years of follow-up.

RESULTS

NSTEMI was the final diagnosis in 14% of patients. CEB levels were higher in patients with NSTEMI compared to other causes of chest pain (median 44 (IQR 21-98) vs. 30 (IQR 16-61), p < .001). A weak but significant correlation between levels of high-sensitivity cardiac troponin T (hs-cTnT) at admission to the ED and the CEB was found (r = .23, p < .001). The use of the CEB in addition to conventional ECG criteria improved the diagnostic accuracy for the diagnosis of NSTEMI as quantified by the area under the receiver operating characteristics curve from 0.66 to 0.71 (p < .001) and the sensitivity improved from 43% to 79% (p < .001).

CONCLUSION

In conclusion, the CEB, an ECG marker of myocardial injury, significantly improves the accuracy and sensitivity of the ECG for the diagnosis of NSTEMI.
Date Issued
2018-07
Publication Type
Article
Subject(s)
Subjects
clinical
•
electrocardiography epidemiology/clinical trials myocardial infarction noninvasive techniques
Language(s)
en
Author(s)
Strebel, Ivo
Twerenbold, Raphael
Boeddinghaus, Jasper
Abächerli, Roger
Rubini Giménez, Maria
Wildi, Karin
Grimm, Karin
Puelacher, Christian
Badertscher, Patrick
Sabti, Zaid
Breitenbücher, Dominik
Jann, Janina
Selman, Farah
du Fay de Lavallaz, Jeanne
Schaerli, Nicolas
Nestelberger, Thomas
Stelzig, Claudia
Freese, Michael
Schumacher, Lukas
Osswald, Stefan
Mueller, Christian
Additional Credits
Journal
Annals of noninvasive electrocardiology
Publisher
Wiley
ISSN
1082-720X
Access(Rights)
restricted
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