Choline for diagnosis and prognostication of acute coronary syndromes in the Emergency Department

R Body, C A Griffith, B Keevil, Garry McDowell, S Carley, J Ferguson, K Mackway-Jones

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Objectives Choline has been identified as a promising marker of coronary inflammation, plaque destabilisation and ischaemia. We sought to evaluate plasma choline levels for rapid confirmation or exclusion of acute myocardial infarction (AMI) in the Emergency Department (ED) and for predicting major adverse cardiac events (MACE). Methods We prospectively recruited 361 patients who presented to the ED with suspected cardiac chest pain within the previous 24 h. Blood was drawn at the time of presentation for plasma choline levels. All patients underwent troponin T testing ≥ 12 h after symptom onset and were followed up for the occurrence of MACE within 6 months. Whole blood choline (WBCho) levels were also measured in a convenience sample of 39 patients. Results Plasma choline levels did not help to predict a diagnosis of AMI (odds ratio (OR) 1.00 (95% confidence intervals (CI) 0.91–1.10, p = 0.98). For a diagnosis of AMI the area under the receiver operating characteristic (ROC) curve was 0.48. Plasma choline was not predictive of the combined endpoint of MACE (OR 1.03, 95% CI 0.95–1.12, p = 0.45) but predicted AMI within 6 months (OR 1.31, 95% CI 1.09–1.56, p = 0.003). WBCho levels were significantly different to plasma levels and were predictive of MACE. Conclusions Plasma choline, measured at the time of ED presentation, is not a diagnostic marker of AMI but predicts AMI within 6 months. While plasma choline failed to predict MACE, WBCho was predictive and warrants further evaluation.
Original languageEnglish
Pages (from-to)89-94
JournalClinica Chimica Acta
Volume404
Issue number2
DOIs
Publication statusPublished - 2009

Fingerprint

Acute Coronary Syndrome
Choline
Hospital Emergency Service
Myocardial Infarction
Plasmas
Blood
Odds Ratio
Confidence Intervals
Troponin T
Chest Pain
ROC Curve
Ischemia
Inflammation
Testing

Cite this

Body, R., Griffith, C. A., Keevil, B., McDowell, G., Carley, S., Ferguson, J., & Mackway-Jones, K. (2009). Choline for diagnosis and prognostication of acute coronary syndromes in the Emergency Department. Clinica Chimica Acta, 404(2), 89-94. https://doi.org/10.1016/j.cca.2009.03.049
Body, R ; Griffith, C A ; Keevil, B ; McDowell, Garry ; Carley, S ; Ferguson, J ; Mackway-Jones, K. / Choline for diagnosis and prognostication of acute coronary syndromes in the Emergency Department. In: Clinica Chimica Acta. 2009 ; Vol. 404, No. 2. pp. 89-94.
@article{c26c970cb10e4c85b2bae5b2d321d636,
title = "Choline for diagnosis and prognostication of acute coronary syndromes in the Emergency Department",
abstract = "Objectives Choline has been identified as a promising marker of coronary inflammation, plaque destabilisation and ischaemia. We sought to evaluate plasma choline levels for rapid confirmation or exclusion of acute myocardial infarction (AMI) in the Emergency Department (ED) and for predicting major adverse cardiac events (MACE). Methods We prospectively recruited 361 patients who presented to the ED with suspected cardiac chest pain within the previous 24 h. Blood was drawn at the time of presentation for plasma choline levels. All patients underwent troponin T testing ≥ 12 h after symptom onset and were followed up for the occurrence of MACE within 6 months. Whole blood choline (WBCho) levels were also measured in a convenience sample of 39 patients. Results Plasma choline levels did not help to predict a diagnosis of AMI (odds ratio (OR) 1.00 (95{\%} confidence intervals (CI) 0.91–1.10, p = 0.98). For a diagnosis of AMI the area under the receiver operating characteristic (ROC) curve was 0.48. Plasma choline was not predictive of the combined endpoint of MACE (OR 1.03, 95{\%} CI 0.95–1.12, p = 0.45) but predicted AMI within 6 months (OR 1.31, 95{\%} CI 1.09–1.56, p = 0.003). WBCho levels were significantly different to plasma levels and were predictive of MACE. Conclusions Plasma choline, measured at the time of ED presentation, is not a diagnostic marker of AMI but predicts AMI within 6 months. While plasma choline failed to predict MACE, WBCho was predictive and warrants further evaluation.",
author = "R Body and Griffith, {C A} and B Keevil and Garry McDowell and S Carley and J Ferguson and K Mackway-Jones",
year = "2009",
doi = "10.1016/j.cca.2009.03.049",
language = "English",
volume = "404",
pages = "89--94",
journal = "Clinica Chimica Acta",
issn = "0009-8981",
publisher = "Elsevier",
number = "2",

}

Body, R, Griffith, CA, Keevil, B, McDowell, G, Carley, S, Ferguson, J & Mackway-Jones, K 2009, 'Choline for diagnosis and prognostication of acute coronary syndromes in the Emergency Department', Clinica Chimica Acta, vol. 404, no. 2, pp. 89-94. https://doi.org/10.1016/j.cca.2009.03.049

Choline for diagnosis and prognostication of acute coronary syndromes in the Emergency Department. / Body, R; Griffith, C A; Keevil, B; McDowell, Garry; Carley, S; Ferguson, J; Mackway-Jones, K.

In: Clinica Chimica Acta, Vol. 404, No. 2, 2009, p. 89-94.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Choline for diagnosis and prognostication of acute coronary syndromes in the Emergency Department

AU - Body, R

AU - Griffith, C A

AU - Keevil, B

AU - McDowell, Garry

AU - Carley, S

AU - Ferguson, J

AU - Mackway-Jones, K

PY - 2009

Y1 - 2009

N2 - Objectives Choline has been identified as a promising marker of coronary inflammation, plaque destabilisation and ischaemia. We sought to evaluate plasma choline levels for rapid confirmation or exclusion of acute myocardial infarction (AMI) in the Emergency Department (ED) and for predicting major adverse cardiac events (MACE). Methods We prospectively recruited 361 patients who presented to the ED with suspected cardiac chest pain within the previous 24 h. Blood was drawn at the time of presentation for plasma choline levels. All patients underwent troponin T testing ≥ 12 h after symptom onset and were followed up for the occurrence of MACE within 6 months. Whole blood choline (WBCho) levels were also measured in a convenience sample of 39 patients. Results Plasma choline levels did not help to predict a diagnosis of AMI (odds ratio (OR) 1.00 (95% confidence intervals (CI) 0.91–1.10, p = 0.98). For a diagnosis of AMI the area under the receiver operating characteristic (ROC) curve was 0.48. Plasma choline was not predictive of the combined endpoint of MACE (OR 1.03, 95% CI 0.95–1.12, p = 0.45) but predicted AMI within 6 months (OR 1.31, 95% CI 1.09–1.56, p = 0.003). WBCho levels were significantly different to plasma levels and were predictive of MACE. Conclusions Plasma choline, measured at the time of ED presentation, is not a diagnostic marker of AMI but predicts AMI within 6 months. While plasma choline failed to predict MACE, WBCho was predictive and warrants further evaluation.

AB - Objectives Choline has been identified as a promising marker of coronary inflammation, plaque destabilisation and ischaemia. We sought to evaluate plasma choline levels for rapid confirmation or exclusion of acute myocardial infarction (AMI) in the Emergency Department (ED) and for predicting major adverse cardiac events (MACE). Methods We prospectively recruited 361 patients who presented to the ED with suspected cardiac chest pain within the previous 24 h. Blood was drawn at the time of presentation for plasma choline levels. All patients underwent troponin T testing ≥ 12 h after symptom onset and were followed up for the occurrence of MACE within 6 months. Whole blood choline (WBCho) levels were also measured in a convenience sample of 39 patients. Results Plasma choline levels did not help to predict a diagnosis of AMI (odds ratio (OR) 1.00 (95% confidence intervals (CI) 0.91–1.10, p = 0.98). For a diagnosis of AMI the area under the receiver operating characteristic (ROC) curve was 0.48. Plasma choline was not predictive of the combined endpoint of MACE (OR 1.03, 95% CI 0.95–1.12, p = 0.45) but predicted AMI within 6 months (OR 1.31, 95% CI 1.09–1.56, p = 0.003). WBCho levels were significantly different to plasma levels and were predictive of MACE. Conclusions Plasma choline, measured at the time of ED presentation, is not a diagnostic marker of AMI but predicts AMI within 6 months. While plasma choline failed to predict MACE, WBCho was predictive and warrants further evaluation.

U2 - 10.1016/j.cca.2009.03.049

DO - 10.1016/j.cca.2009.03.049

M3 - Article

VL - 404

SP - 89

EP - 94

JO - Clinica Chimica Acta

JF - Clinica Chimica Acta

SN - 0009-8981

IS - 2

ER -