Christian Puelacher
A5010633320- Acute Myocardial Infarction Research
- Cardiac Imaging and Diagnostics
- Cardiac, Anesthesia and Surgical Outcomes
- Heart Failure Treatment and Management
- Hemodynamic Monitoring and Therapy
- Coronary Interventions and Diagnostics
- Atrial Fibrillation Management and Outcomes
- Cardiac electrophysiology and arrhythmias
- Hip and Femur Fractures
- Aortic aneurysm repair treatments
- Venous Thromboembolism Diagnosis and Management
- Cardiovascular Effects of Exercise
- Cardiovascular Syncope and Autonomic Disorders
- Cardiac Arrhythmias and Treatments
- ECG Monitoring and Analysis
- Sepsis Diagnosis and Treatment
- Cardiac Valve Diseases and Treatments
- Cardiac Arrest and Resuscitation
- Blood Pressure and Hypertension Studies
- Lipoproteins and Cardiovascular Health
- Electrolyte and hormonal disorders
- Cardiovascular Function and Risk Factors
- Infective Endocarditis Diagnosis and Management
- Antimicrobial Resistance in Staphylococcus
- Chronic Disease Management Strategies
University Hospital of Basel
2016-2025
Innsbruck Medical University
2024-2025
Universität Innsbruck
2024-2025
University of Basel
2017-2024
University Hospital Innsbruck
2024
Cardiovascular Institute Hospital
2016-2024
Universidade do Porto
2023
University College London
2023
Iberoamerican Cochrane Centre
2023
Inserm
2023
Perioperative myocardial injury (PMI) seems to be a contributor mortality after noncardiac surgery. Because the vast majority of PMIs are asymptomatic, PMI usually is missed in absence systematic screening. We performed prospective diagnostic study enrolling consecutive patients undergoing surgery who had planned postoperative stay ≥24 hours and were considered at increased cardiovascular risk. All received screening using serial measurements high-sensitivity cardiac troponin T clinical...
<h3>Background:</h3> We aimed to prospectively validate a novel 1-hour algorithm using high-sensitivity cardiac troponin T measurement for early rule-out and rule-in of acute myocardial infarction (MI). <h3>Methods:</h3> In multicentre study, we enrolled 1320 patients presenting the emergency department with suspected MI. The algorithm, incorporating baseline values as well absolute changes within first hour, was validated against final diagnosis. diagnosis then adjudicated by 2 independent...
It is unknown whether more sensitive cardiac troponin (cTn) assays maintain their clinical utility in patients with renal dysfunction. Moreover, optimal cutoff levels this vulnerable patient population have not previously been defined.In multicenter study, we examined the of 7 cTn (3 and 4 high-sensitivity assays) presenting symptoms suggestive acute myocardial infarction. Among 2813 unselected patients, 447 (16%) had dysfunction (defined as Modification Diet Renal Disease-estimated...
Cardiac troponin (cTn) T and cTnI are considered cardiac specific equivalent in the diagnosis of acute myocardial infarction. Previous studies suggested rare skeletal myopathies as a noncardiac source cTnT. We aimed to confirm reliability/cardiac specificity cTnT patients with various muscle disorders (SMDs).We prospectively enrolled presenting muscular complaints (≥2 weeks) for elective evaluation 4 hospitals 2 countries. After workup, were adjudicated into 3 predefined disease categories....
Abstract Aims Perioperative myocardial infarction/injury (PMI) following non-cardiac surgery is a frequent cardiac complication. Better understanding of the underlying aetiologies and outcomes urgently needed. Methods results Aetiologies PMIs detected within an active surveillance response programme were centrally adjudicated by two independent physicians based on all information obtained during clinically indicated PMI work-up including imaging among consecutive high-risk patients...
BACKGROUND In recent years, there has been increasing focus on the use of cardiac biomarkers in patients undergoing noncardiac surgery. AIMS The aim this focused guideline was to provide updated guidance regarding pre-, post- and combined pre-and postoperative troponin B-type natriuretic peptides adult METHODS guidelines were prepared using Grading Recommendations Assessment Development Evaluation (GRADE) methodology. This included definition critical outcomes, a systematic literature...
High-sensitivity cardiac troponin (hs-cTn) assays provide higher diagnostic accuracy for acute myocardial infarction (AMI) when compared with conventional assays, but may result in increased use of unnecessary coronary angiographies due to their detection cardiomyocyte injury conditions other than AMI.We evaluated the impact clinical introduction high-sensitivity T (hs-cTnT) on angiography, stress testing, and time discharge 2544 patients presenting symptoms suggestive AMI emergency...
Background: Four strategies for very early rule-out of acute myocardial infarction using high-sensitivity cardiac troponin I (hs-cTnI) have been identified. It remains unclear which strategy is most attractive clinical application. Methods: We prospectively enrolled unselected patients presenting to the emergency department with symptoms suggestive infarction. The final diagnosis was adjudicated by 2 independent cardiologists. Hs-cTnI levels were measured at presentation and after 1 hour in...
The European Society of Cardiology recommends a 0/1-hour algorithm for rapid rule-out and rule-in non-ST-segment elevation myocardial infarction using high-sensitivity cardiac troponin (hs-cTn) concentrations irrespective renal function. Because patients with dysfunction (RD) frequently present increased hs-cTn even in the absence infarction, concern has been raised regarding performance RD. In prospective multicenter diagnostic study enrolling unselected presenting suspected to emergency...
Abstract BACKGROUND Clinical performance of the novel high-sensitivity cardiac troponin I (Siemens-hs-cTnI-Centaur) assay is unknown. We aimed to clinically validate Siemens-hs-cTnI-Centaur and develop 0/1-h 0/2-h algorithms. METHODS enrolled patients presenting emergency department with symptoms suggestive acute myocardial infarction (AMI). Final diagnoses were centrally adjudicated by 2 independent cardiologists including all clinical information twice: first, using serial hs-cTnT...
Until now, high-sensitivity cardiac troponin (hs-cTn) assays were mainly developed for large central laboratory platforms. This study aimed to assess the clinical performance of a point-of-care (POC)-hs-cTnI assay in patients with suspected myocardial infarction (MI). enrolled presenting emergency department symptoms suggestive MI. Two cardiologists centrally adjudicated final diagnosis using all data including imaging. The primary objective was directly compare diagnostic accuracy...
Background— Misdiagnosis of acute myocardial infarction (AMI) may significantly harm patients and result from inappropriate clinical decision values (CDVs) for cardiac troponin (cTn) owing to limitations in the current regulatory process. Methods Results— In an international, prospective, multicenter study, we quantified incidence inconsistencies diagnosis AMI using fully characterized clinically available high-sensitivity (hs) cTn assays (hs-cTnI, Abbott; hs-cTnT, Roche) among 2300...
Abstract BACKGROUND The early triage of patients toward rule-out and rule-in acute myocardial infarction (AMI) is challenging. Therefore, we aimed to develop a 2-h algorithm that uses high-sensitivity cardiac troponin I (hs-cTnI). METHODS We prospectively enrolled 1435 (derivation cohort) 1194 (external validation presenting with suspected AMI the emergency department. final diagnosis was adjudicated by 2 independent cardiologists. hs-cTnI measured at presentation after h in blinded fashion....
We aimed to evaluate the impact of age on performance European Society Cardiology (ESC) 0/1h-algorithms and derive externally validate alternative cut-offs specific older patients.We prospectively enrolled patients presenting emergency department (ED) with symptoms suggestive acute myocardial infarction in three large diagnostic studies. Final diagnoses were adjudicated by two independent cardiologists. High-sensitivity cardiac troponin (hs-cTn) T I concentrations measured at presentation...
It is currently unknown whether the uniform (universal clinical practice for more than 2 decades) or sex-specific cutoff levels are preferable when using high-sensitivity cardiac troponin T (hs-cTnT) in diagnosis of acute myocardial infarction (AMI).To improve management suspected AMI women by exploring vs hs-cTnT.In an ongoing prospective, diagnostic, multicenter study conducted at 9 emergency departments, present evaluated patients enrolled from April 21, 2006, through June 5, 2013. The...
Major adverse cardiac events (MACE) triggered by non-cardiac surgery are prognostically important perioperative complications. However, due to often asymptomatic presentation, the incidence and timing of postoperative MACE incompletely understood.
The aim of this study was to validate the clinical performance Beckman Access high-sensitivity cardiac troponin I (hs-cTnI) assay.We enrolled patients presenting emergency department with symptoms suggestive acute myocardial infarction (AMI). Final diagnoses were centrally adjudicated by 2 independent cardiologists all information including imaging twice: first, using serial hs-cTnT (Elecsys, primary analysis), and second, hs-cTnI (Architect, secondary analysis) measurements in addition...
Collaboration for the Diagnosis and Evaluation of Acute Coronary Syndrome (CoDE-ACS) is a validated clinical decision support tool that uses machine learning with or without serial cardiac troponin measurements at flexible time point to calculate probability myocardial infarction (MI). How CoDE-ACS performs different points measurement compares guideline-recommended diagnostic pathways rely on fixed thresholds uncertain.