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Diagnostic performance and optimal cut-off values of cardiac biomarkers for predicting cardiac injury in carbon monoxide poisoning

Title
Diagnostic performance and optimal cut-off values of cardiac biomarkers for predicting cardiac injury in carbon monoxide poisoning
Author
임태호
Keywords
Carbon monoxide; Poisoning; Echocardiography
Issue Date
2020-02
Publisher
Korean Society of Emergency Medicine
Citation
Clinical and Experimental Emergency Medicine, v. 7, no. 3, page. 183-189
Abstract
Objective: This study aimed to compare the diagnostic performance of cardiac biomarkers and to evaluate the optimal cut-off values for echocardiographic cardiac injury prediction in patients with carbon monoxide (CO) poisoning. Methods: This retrospective observational cohort study included adult patients with acute CO poisoning. Patients who did not undergo transthoracic echocardiography, which was used to define patients with cardiac injury (ejection fraction <55%), were excluded. The area under the curve was used to evaluate diagnostic performance for cardiac injury prediction. Mann-Whitney U, chi-square, and Fisher exact tests were used to analyze data. Results: After excluding the 27 patients who did not undergo echocardiography, 114 patients were included in the study. Fifteen (13.2%) patients had cardiac injury. The area under the curve values for the B-type natriuretic peptide, creatine kinase-myocardial band, and troponin I were 0.711 (95% confidence interval [CI], 0.527–0.895; P=0.011), 0.766 (95% CI, 0.607–0.926; P=0.001), and 0.801 (95% CI, 0.647–0.955; P<0.001), respectively, with optimal cut-off values of 330 pg/mL, 10.1 ng/mL, and 0.455 ng/mL, respectively. The sensitivity, specificity, and positive and negative predictive values of troponin I were 67%, 91%, 53%, and 95%, respectively. Conclusion: Troponin I showed the best diagnostic performance for predicting cardiac injury in patients with CO poisoning. A cut-off value of 0.455 ng/mL appeared optimal for cardiac injury prediction. However, further studies on cardiac biomarkers and other diagnostic tools in CO poisoning are needed given the low sensitivity of troponin I.
URI
https://www.ceemjournal.org/journal/view.php?doi=10.15441/ceem.19.072https://repository.hanyang.ac.kr/handle/20.500.11754/161262
ISSN
2383-4625
DOI
10.15441/ceem.19.072
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COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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