Citations 2
Cardiac troponin elevation and mortality in takotsubo syndrome: New insights from the international takotsubo registry
Stähli, Barbara E. , Schindler, Matthias , Schweiger, Victor , Cammann, Victoria L. , Szawan, Konrad A. , Niederseer, David , Würdinger, Michael , Schönberger, Alexander, Schönberger, Maximilian, Koleva, Iva, Mercier, Julien C., Petkova, Vanya, Mayer, Silvia, Gili, Sebastiano , Franke, Jennifer , Meder, Benjamin , Jaguszewski, Miłosz, Knorr, Maike, Jansen, Thomas , Lewinski, Dirk von , Burgdorf, Christof , Kherad, Behrouz , Tschöpe, Carsten , Sarcon, Annahita, Shinbane, Jerold S., Rajan, Lawrence, Michels, Guido, Pfister, Roman , Jacobshagen, Claudius, Karakas, Mahir , Pott, Alexander , Meyer, Philippe , Roffi, Marco , Wolfrum, Mathias , Fischer, Thomas, Vasankari, Tuija , Dworakowski, Rafał , MacCarthy, Philip , Osswald, Stefan , Galiuto, Leonarda , Chan, Christina , Bridgman, Paul , Beug, Daniel , Gilyarova, Ekaterina, Gilyarov, Mikhail , Akın, İbrahim , Poledníková, Karolína, Massoomi, Michael , Carrilho‐Ferreira, Pedro , Hauck, Christian , Paolini, Carla , Bilato, Claudio , Kobayashi, Yoshio , Ishibashi, Iwao, Himi, Toshiharu, Din, Jehangir , Rihal, Charanjit S. , Liu, Kan , Jörg, Lucas, Rickli, Hans , Böhm, M., Pinto, Fausto J. , Widimský, Petr , Felix, Stephan B. , Rottbauer, Wolfgang , Budnik, Monika , Opolski, Grzegorz , Thiele, Holger, Kong, William, Dalakoti, Mayank , Imori, Yoichi , Liberale, Luca , Münzel, Thomas , Bax, J. J., Ghadri, Jelena R. , Vece, Davide Di , Templin, Christian , Budnik, Monika , Roffi, Marco , Liberale, Luca , Montecucco, Fabrizio , von Lewinski, Dirk , Tschöpe, Carsten , Meyer, Philippe , Bilato, Claudio , Citro, Rodolfo , Vecchione, Carmine , Bossone, Eduardo , Neuhaus, Michael, Noutsias, Michel , D’Ascenzo, Fabrizio, Dichtl, Wolfgang , Cuneo, Alessandro , Köenig, Wolfgang , Banning, Adrian , Cuculi, Florim , Kobza, Richard , Airaksinen, Juhani , Napp, L. Christian , Kaiser, Christoph A. , Delmas, Clément , Lairez, Olivier , Shilova, Alexandra S. , El‐Battrawy, Ibrahim , Toušek, Petr , Winchester, David E. , Gałuszka, Jan , Ukena, Christian , Poglajen, Gregor , Kato, Ken , Al‐Shammari, Ali Saad , Prasad, Abhiram , Rihal, Charanjit S. , Schulze, Paul Christian , Bianco, Matteo , Pestana, Gonçalo , Nguyen, Thanh Ha Tuan , Maier, Lars S. , Braun-Dullaeus, Ruediger Christian , Hasenfuß, Gerd , Pieske, Burkert , Schunkert, Heribert , Thiele, Holger , Bauersachs, Johann , Horowitz, John D. , Mario, Carlo Di , Crea, Filippo , Luescher, T F , Ruschitzka, Frank T.
European Journal of Clinical Investigation | October 14, 2024 | Volume: 54 | Issue: 12 | Pages: No page available
AbstractBackgroundThe clinical relevance of cardiac troponin (cTn) elevation in takotsubo syndrome (TTS) remains uncertain. The present study sought to investigate the role of cardiac troponin (cTn) elevations in mortality prediction of patients with Takotsubo syndrome (TTS).MethodsPatients enrolled in the International Takotsubo (InterTAK) Registry from January 2011 to February 2020 with available data on peak cTn levels were included in the analysis. Peak cTn levels during the index hospitalization were used to define clinically relevant myocardial injury. The threshold at which clinically relevant myocardial injury drives mortality at 1 year was identified using restricted cubic spline analysis.ResultsOut of 2′938 patients, 222 (7.6%) patients died during 1‐year follow‐up. A more than 28.8‐fold increase of cTn above the upper reference limit was identified as threshold for clinically relevant myocardial injury. The presence of clinically relevant myocardial injury was significantly associated with an increased risk of mortality at 5 years (adjusted HR 1.58, 95% CI 1.18–2.12, p =.002). Clinically relevant myocardial injury was related to an increased 5‐year mortality risk in patients with apical TTS (adjusted HR 1.57, 95% CI 1.21–2.03, p =.001), in presence of physical stressors (adjusted HR 1.60, 95% CI 1.22–2.11, p =.001), and in absence of emotional stressors (adjusted HR 1.49, 95% CI, 1.17–1.89, p =.001).ConclusionThis study for the first time determined a troponin threshold for the identification of TTS patients at excess risk of mortality. These findings advance risk stratification in TTS and assist in identifying patients in need for close monitoring and follow‐up.
Artificial intelligence in cardiovascular medicine: clinical applications
Lüscher, Thomas F. , Wenzl, Florian A. , D’Ascenzo, Fabrizio , Friedman, Paul A. , Antoniades, Charalambos , Luescher, T F
European Heart Journal | July 17, 2024 | Volume: 45 | Issue: 40 | Pages: 4291-4304
Abstract Clinical medicine requires the integration of various forms of patient data including demographics, symptom characteristics, electrocardiogram findings, laboratory values, biomarker levels, and imaging studies. Decision-making on the optimal management should be based on a high probability that the envisaged treatment is appropriate, provides benefit, and bears no or little potential harm. To that end, personalized risk–benefit considerations should guide the management of individual patients to achieve optimal results. These basic clinical tasks have become more and more challenging with the massively growing data now available; artificial intelligence and machine learning (AI/ML) can provide assistance for clinicians by obtaining and comprehensively preparing the history of patients, analysing face and voice and other clinical features, by integrating laboratory results, biomarkers, and imaging. Furthermore, AI/ML can provide a comprehensive risk assessment as a basis of optimal acute and chronic care. The clinical usefulness of AI/ML algorithms should be carefully assessed, validated with confirmation datasets before clinical use, and repeatedly re-evaluated as patient phenotypes change. This review provides an overview of the current data revolution that has changed and will continue to change the face of clinical medicine radically, if properly used, to the benefit of physicians and patients alike.