Chest Pain in Cancer Patients: Prevalence of Myocardial Infarction and Performance of High-Sensitivity Cardiac Troponins
Authors' conclusion
Patients with cancer have a substantially higher prevalence of AMI as the cause of chest pain. Length of ED stay and hospitalization rates are increased. The diagnostic performance of hs-cTnT and the efficacy of both the European Society of Cardiology 0/1-hour hs-cTnT and hs-cTnI algorithms is reduced.
Study context
- Population
- Patients presenting with chest pain to the emergency department (ED)8,093 eligible for acute myocardial infarction (AMI) analyses
- Participants
- 8,267 patients
- Comparison
- Cancer vs no cancer
- Cancern = 711
- Outcome
- Prevalence of AMI
Methodological detailsinternational multicentre, central adjudication, external validation cohort
- International multicentre
- Central adjudication
- External validation cohort
Performance
As reported in the abstract
Final diagnosis of AMI
P < 0.001
Further findings
Total length of ED stay
P < 0.001
Hospitalization rate
P < 0.001
| Outcome | Cancer | No cancer | P value |
|---|---|---|---|
| Diagnostic accuracy of hs-cTnT for NSTEMI | P < 0.001 | ||
| AUC | 0.89 (95% CI: 0.86-0.92) | 0.94 (95% CI: 0.93-0.94) | |
| Diagnostic accuracy of hs-cTnI for NSTEMI | P = 0.10 | ||
| AUC | 0.93 (95% CI: 0.91-0.95) | 0.95 (95% CI: 0.94-0.95) |
ESC 0/1-hour high-sensitivity cardiac troponin T (hs-cTnT) and high sensitivity cardiac troponin I (hs-cTnI) algorithms in cancer
- Very high safety maintained but lower efficacy, with twice the number of patients in the observe zone
- Similar findings in the external validation cohort
Original publication
Chest Pain in Cancer Patients: Prevalence of Myocardial Infarction and Performance of High-Sensitivity Cardiac Troponins. JACC CardioOncol. Published 26 August 2023. doi:10.
Summarised from the published abstract; every number is checked against it