Curtin University Homepage
  • Library
  • Help
    • Admin

    espace - Curtin’s institutional repository

    JavaScript is disabled for your browser. Some features of this site may not work without it.
    View Item 
    • espace Home
    • espace
    • Curtin Research Publications
    • View Item
    • espace Home
    • espace
    • Curtin Research Publications
    • View Item

    Can we monitor heart attack in the troponin era: Evidence from a population-based cohort study

    203757_115219_81868_publication.pdf (182.8Kb)
    Access Status
    Open access
    Authors
    Sanfilippo, F.
    Hobbs, M.
    Knuiman, M.
    Ridout, S.
    Bradshaw, P.
    Finn, Judith
    Rankin, J.
    Spivulis, P.
    Hung, J.
    Date
    2011
    Type
    Journal Article
    
    Metadata
    Show full item record
    Citation
    Sanfilippo, F. and Hobbs, M. and Knuiman, M. and Ridout, S. and Bradshaw, P. and Finn, J. and Rankin, J. et al. 2011. Can we monitor heart attack in the troponin era: Evidence from a population-based cohort study. BMC Cardiovascular Disorders. 11: 35.
    Source Title
    BMC Cardiovascular Disorders
    DOI
    10.1186/1471-2261-11-35
    ISSN
    1471-2261
    Remarks

    This article is published under the Open Access publishing model and distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/2.0/ Please refer to the licence to obtain terms for any further reuse or distribution of this work.

    URI
    http://hdl.handle.net/20.500.11937/4225
    Collection
    • Curtin Research Publications
    Abstract

    Background: Troponins (highly sensitive biomarkers of myocardial damage) increase counts of myocardial infarction (MI) in clinical practice, but their impact on trends in admission rates for MI in National statistics is uncertain. Methods: Cases coded as MI or other cardiac diagnoses in the Hospital Morbidity Data Collection (MI-HMDC) in Western Australia in 1998 and 2003 were classified using revised criteria for MI developed by an International panel convened by the American Heart Association (AHA criteria) using information on symptoms, ECGs and cardiac biomarkers abstracted from samples of medical notes. Age-sex standardized rates of MI-HMDC were compared with rates of MI based on AHA criteria including troponins (MI-AHA) or traditional biomarkers only (MI-AHAck). Results: Between 1998 and 2003, rates of MI-HMDC decreased by 3.5% whereas rates of MI-AHA increased by 17%, a difference largely due to increased false-negative cases in the HMDC associated with marked increased use of troponin tests in cardiac admissions generally, and progressively lower test thresholds. In contrast, rates of MIAHAck declined by 18%. Conclusions: Increasing misclassification of MI-AHA by the HMDC may be due to reluctance by clinicians to diagnose MI based on relatively small increases in troponin levels. These influences are likely to continue. Monitoring MI using AHA criteria will require calibration of commercially available troponin tests and agreement on lower diagnostic thresholds for epidemiological studies. Declining rates of MI-AHAck are consistent with longstanding trends in MI in Western Australia, suggesting that neither MI-HMDC nor MI-AHA reflect the true underlying population trends in MI.

    Related items

    Showing items related by title, author, creator and subject.

    • Short-term risk of adverse outcome is significantly higher in patients returning an abnormal troponin result when tested in the emergency department
      Flindell, J.; Finn, Judith; Gibson, N.; Jacobs, Ian (2009)
      Objective: Describe short-term mortality and hospitalization outcomes in patients undergoing troponin testing in Western Australia tertiary public hospital ED. Methods: Retrospective cohort study of adults presenting to ...
    • Air versus oxygen in ST-segment-elevation myocardial infarction
      Stub, D.; Smith, K.; Bernard, S.; Nehme, Z.; Stephenson, M.; Bray, Janet; Cameron, P.; Barger, B.; Ellims, A.; Taylor, A.; Meredith, I.; Kaye, D. (2015)
      Background: Oxygen is commonly administered to patients with ST-elevation-myocardial infarction despite previous studies suggesting a possible increase in myocardial injury as a result of coronary vasoconstriction and ...
    • Developing completion criteria for rehabilitation areas on arid and semi-arid mine sites in Western Australia
      Brearley, Darren (2003)
      Continued expansion of the gold and nickel mining industry in Western Australia during recent years has led to disturbance of larger areas and the generation of increasing volumes of waste rock. Mine operators are obligated ...
    Advanced search

    Browse

    Communities & CollectionsIssue DateAuthorTitleSubjectDocument TypeThis CollectionIssue DateAuthorTitleSubjectDocument Type

    My Account

    Admin

    Statistics

    Most Popular ItemsStatistics by CountryMost Popular Authors

    Follow Curtin

    • 
    • 
    • 
    • 
    • 

    CRICOS Provider Code: 00301JABN: 99 143 842 569TEQSA: PRV12158

    Copyright | Disclaimer | Privacy statement | Accessibility

    Curtin would like to pay respect to the Aboriginal and Torres Strait Islander members of our community by acknowledging the traditional owners of the land on which the Perth campus is located, the Whadjuk people of the Nyungar Nation; and on our Kalgoorlie campus, the Wongutha people of the North-Eastern Goldfields.