Auxiliary roles of nardilysin in the early diagnosis of acute coronary syndrome: a prospective cohort study, the Nardi-ACS study
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Published:2024-01-17
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ISSN:1828-0447
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Container-title:Internal and Emergency Medicine
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language:en
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Short-container-title:Intern Emerg Med
Author:
Ohno Mikiko, Shiomi Hiroki, Baba Osamu, Yano Mariko, Aizawa Takanori, Nakano-Matsumura Yukiko, Yamagami Shintaro, Kato Masashi, Ohya Masanobu, Chen Po-Min, Nagao Kazuya, Ando Kenji, Yokomatsu Takafumi, Kadota Kazushige, Kouchi Ichiro, Inada Tsukasa, Valentine Cindy, Kitagawa Takahiro, Kurokawa Masato, Ohtsuru Shigeru, Morimoto Takeshi, Kimura Takeshi, Nishi EiichiroORCID
Abstract
AbstractAcute coronary syndrome (ACS) includes myocardial infarction (MI) and unstable angina (UA). MI is defined by elevated necrosis markers, preferably high-sensitivity cardiac troponins (hs-cTn). However, it takes hours for cTn to become elevated after coronary occlusion; therefore, difficulties are associated with diagnosing early post-onset MI or UA. The aim of this prospective cohort study was to examine the diagnostic ability of serum nardilysin (NRDC) for the early detection of ACS. This study consisted of two sequential cohorts, the Phase I cohort, 435 patients presenting to the emergency room (ER) with chest pain, and the Phase II cohort, 486 patients with chest pain who underwent coronary angiography. The final diagnosis was ACS in 155 out of 435 patients (35.6%) in the phase I and 418 out of 486 (86.0%) in the phase II cohort. Among 680 patients who presented within 24 h of onset, 466 patients (68.5%) were diagnosed with ACS. Serum NRDC levels were significantly higher in patients with ACS than in those without ACS. The sensitivity of NRDC in patients who presented within 6 h after the onset was higher than that of hsTnI, and the AUC of NRDC within 1 h of the onset was higher than that of hsTnI (0.718 versus 0.633). Among hsTnI-negative patients (300 of 680 patients: 44.1%), 136 of whom (45.3%) were diagnosed with ACS, the sensitivity and the NPV of NRDC were 73.5 and 65.7%, respectively. When measured in combination with hsTnI, NRDC plays auxiliary roles in the early diagnosis of ACS.
Funder
Takeda Science Foundation Naito Foundation NOVARTIS Foundation (Japan) for the Promotion of Science Kobayashi International Scholarship Foundation Japan Society for the Promotion of Science Murata Science Foundation
Publisher
Springer Science and Business Media LLC
Subject
Emergency Medicine,Internal Medicine
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