Serum Calretinin as a Biomarker in Malignant Mesothelioma

The early diagnosis of malignant mesothelioma (MM) could improve the prognosis of MM patients. To confirm an MM diagnosis, an immunohistochemical analysis of several tumor tissue markers, including calretinin, is currently required. Our aim is to evaluate serum calretinin as a potential biomarker in asbestos-related diseases, especially in MM. Our study includes 549 subjects: 164 MM patients, 117 subjects with asbestosis, 195 subjects with pleural plaques and 73 occupationally asbestos-exposed subjects without asbestos-related diseases. The serum calretinin concentration was determined with a commercially available enzyme immunoassay. Data on the soluble mesothelin-related peptides (SMRP) concentration are available from previous studies. MM patients had a significantly higher calretinin concentration than subjects without disease, subjects with pleural plaques or subjects with asbestosis (all p < 0.001). The histological type was significantly associated with serum calretinin: patients with sarcomatoid MM had lower calretinin than patients with the epithelioid type (p = 0.001). In a ROC curve analysis, the area under the curve for calretinin concentration predicting MM was 0.826 (95% CI = 0.782–0.869; p < 0.001). At the cutoff value of 0.32 ng/mL, sensitivity was 0.683, while specificity was 0.886. The combination of calretinin and SMRP had the highest predictive value. Calretinin is a useful biomarker that can distinguish MM from other asbestos-related diseases and could, therefore, contribute to an earlier non-invasive diagnosis of MM.

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Combination of transient elastography with serum-based non-invasive tests improves prediction of liver fibrosis in patients with chronic hepatitis C: a prospective cohort study

Acta medica Lituanica ◽

10.6001/actamedica.v22i2.3122 ◽

2015 ◽

Vol 22 (2) ◽

pp. 77-84

Author(s):

Romanas Zykus ◽

Laimas Jonaitis ◽

Vitalija Petrenkienė ◽

Inga Gudinavičienė ◽

Limas Kupčinskas

Keyword(s):

Liver Fibrosis ◽

Transient Elastography ◽

Curve Analysis ◽

Roc Curve Analysis ◽

Cutoff Value ◽

Non Invasive ◽

Metavir Score ◽

Combined Use ◽

Chronic Hcv ◽

Histological Stage

The work was carried out at the Lithuanian University of Health Sciences Hospital Kaunas Clinics. Background. To date, there is not enough data to conclude whether the combination of different non-invasive liver fibrosis tests could improve the accuracy in prediction of liver fibrosis. The aim of this study was to assess correlation between transient elastography (TE), aspartate aminotransferase to platelet ratio index (APRI), fibrosis 4 score (FIB4) and histological stage of fibrosis (F). Materials and methods. In this prospective study the correlation of TE, APRI and FIB4 with the stage of fibrosis was assessed in 140 patients with chronic HCV hepatitis. TE, APRI and FIB4 were measured the same day before biopsy. Fibrosis was evaluated using the METAVIR score. Cut-off values were established by applying the ROC curve analysis. All non-invasive tests were combined into pairs in order to evaluate the accuracy of fibrosis prediction. Results. The stage of fibrosis correlated with TE (R-0.74), FIB4 (R-0.67) and APRI (R-0.58). To detect F4 TE cut-off value 12.1 kPa had 93.8% sensitivity and 85% specificity; APRI cut-off value 1.42 (84.4/81.1) and FIB4 cutoff value 2.89 (84.4/84.0) were established. To determine F ≥ 3 – 10.3 kPa (91.1/83.9), 1.28 (77.8/78.5), 2.28 (84.4/81.7); F ≥ 2 8.5 kPa (80.9/74.3), 1.12 (72.1/78.6), 1.63 (82.4/75.7); F ≥ 1 5.35 kPa (85.4/100), 0.45 (89.2/87.5), 0.89 (87.7/75). Significant increase of accuracy was observed in TE/APRI (p – 0.008) and FIB4/APRI (p – 0.02) groups to predict F ≥ 1, and TE/FIB4 to predict F ≥ 2 (p – 0.04) and F ≥ 1 (p – 0.04). Conclusions. Combined use of TE/APRI, FIB4/APRI increased the accuracy to predict F ≥ 1, and TE/FIB4 combination increased the accuracy to predict F ≥ 2 and F ≥ 1.

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The Predictive Value of Language Scales: Bayley Scales of Infant and Toddler Development Third Edition in Correlation With Korean Sequenced Language Scale for Infant

Annals of Rehabilitation Medicine ◽

10.5535/arm.19198 ◽

2020 ◽

Vol 44 (5) ◽

pp. 378-385

Author(s):

Joung Hyun Doh ◽

Soo A Kim ◽

Kiyoung Oh ◽

Yuntae Kim ◽

Nodam Park ◽

...

Keyword(s):

Roc Curve ◽

Area Under The Curve ◽

Curve Analysis ◽

Roc Curve Analysis ◽

Optimal Cutoff ◽

Cutoff Value ◽

Average Group ◽

Toddler Development ◽

Relationship Of ◽

Bayley Scales

Objective To compare the relationship of the Bayley Scales of Infant and Toddler Development 3rd Edition (K-BSID-III) language score and the Sequenced Language Scale for Infant (SELSI) score and evaluate the sensitivity and specificity of K-BSID-III language score and optimal cutoff value with receiver operator characteristic (ROC) curve analysis in infants and toddlers with delayed language development.Methods A total of 104 children with suspected language developmental delay were included in this retrospective study. Subjects were tested using the K-BSID-III and SELSI and subdivided into several groups according to the severity of language scores. ROC curve analysis was performed to assess K-BSID-III for delayed language development.Results Receptive and expressive language subscales of the K-BSID-III showed markedly significant correlation with the SELSI scores (p<0.001). ROC analysis showed an area under the curve of 0.877 (p<0.001) in SELSI receptive score and 0.935 (p<0.001) in SELSI expressive score. The optimal cutoff value where sensitivity of 85% and specificity of 81% were achieved with the K-BSID-III receptive score was 1.50 (between average and low average) in the SELSI receptive score. The optimal cutoff value where sensitivity of 96% and specificity of 82% were achieved with the K-BSID-III expressive score was also 1.50 in the SELSI expressive score.Conclusion In this study, the correlations between K-BSID-III and SELSI language scores were statistically significant. However, the interpretation should be considered carefully in low average group due to tendency of underestimation of delayed language development.

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Ascitic pseudouridine discriminates between hepatocarcinoma-derived ascites and cirrhotic ascites

Clinical Chemistry ◽

10.1093/clinchem/42.11.1843 ◽

1996 ◽

Vol 42 (11) ◽

pp. 1843-1846 ◽

Cited By ~ 6

Author(s):

G Castaldo ◽

M Intrieri ◽

G Calcagno ◽

L Cimino ◽

G Budillon ◽

...

Keyword(s):

Liver Biopsy ◽

Roc Curve ◽

Curve Analysis ◽

Diagnostic Sensitivity ◽

Serum Concentrations ◽

Diagnostic Specificity ◽

Roc Curve Analysis ◽

Neoplastic Cells ◽

Cutoff Value ◽

Cirrhotic Patients

Abstract Various biochemical indexes discriminate neoplastic from nonneoplastic ascites. However, within the latter group, the distinction between cirrhotic ascites and ascites caused by hepatocarcinoma (HC) is usually based on liver biopsy or cytology. HC-derived ascites is included in the group of nonneoplastic ascites because it is not associated with peritoneal spreading of neoplastic cells. In 54 cases of cirrhotic ascites and 17 cases of HC ascites, all histologically diagnosed, ascitic pseudouridine concentrations discriminated cirrhotic from HC ascites. For example, using the cutoff value of 4.25 mumol/L (obtained by ROC curve analysis) resulted in a diagnostic sensitivity of 88.2% and a diagnostic specificity of 90.8%. Moreover, in cirrhosis, the ascitic concentrations of pseudouridine were lower than serum concentrations, and the two sets of values were correlated; in HC, however, ascitic pseudouridine concentrations were higher than serum concentrations, and the two were unrelated. These findings strongly suggest that in cirrhotic patients ascitic pseudouridine derives from serum by diffusion, whereas in HC patients the mechanism appears to be more complex.

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D-dimer as a biomarker for assessment of COVID-19 prognosis: D-dimer levels on admission and its role in predicting disease outcome in hospitalized patients with COVID-19

PLoS ONE ◽

10.1371/journal.pone.0256744 ◽

2021 ◽

Vol 16 (8) ◽

pp. e0256744

Author(s):

Ayusha Poudel ◽

Yashasa Poudel ◽

Anurag Adhikari ◽

Barun Babu Aryal ◽

Debika Dangol ◽

...

Keyword(s):

Proportional Hazards ◽

Characteristic Curve ◽

Area Under The Curve ◽

Respiratory Illness ◽

Immunofluorescence Assay ◽

Cox Proportional Hazards ◽

Optimal Cutoff ◽

Cutoff Value ◽

Potential Biomarker ◽

D Dimer

Introduction Coronavirus Disease 2019 is a primarily respiratory illness that can cause thrombotic disorders. Elevation of D-dimer is a potential biomarker for poor prognosis in COVID-19, though optimal cutoff value for D-dimer to predict mortality has not yet been established. This study aims to assess the accuracy of admission D-dimer in the prognosis of COVID-19 and to establish the optimal cutoff D-dimer value to predict hospital mortality. Methods Clinical and laboratory parameters and outcomes of confirmed COVID-19 cases admitted to four hospitals in Kathmandu were retrospectively analyzed. Admitted COVID-19 cases with recorded D-dimer and definitive outcomes were included consecutively. D-dimer was measured using immunofluorescence assay and reported in Fibrinogen Equivalent Unit (μg/ml). The receiver operating characteristic curve was used to determine the accuracy of D-dimer in predicting mortality, and to calculate the optimal cutoff value, based on which patients were divided into two groups and predictive value of D-dimer for mortality was measured. Results 182 patients were included in the study out of which 34(18.7%) died during the hospital stay. The mean admission D-dimer among surviving patients was 1.067 μg/ml (±1.705 μg/ml), whereas that among patients who died was 3.208 μg/ml (±2.613 μg/ml). ROC curve for D-dimer and mortality gave an area under the curve of 0.807 (95% CI 0.728–0.886, p<0.001). Optimal cutoff value for D-dimer was 1.5 μg/ml (sensitivity 70.6%, specificity 78.4%). On Cox proportional hazards regression analysis, the unadjusted hazard ratio for high D-dimer was 6.809 (95% CI 3.249–14.268, p<0.001), and 5.862 (95% CI 2.751–12.489, p<0.001) when adjusted for age. Conclusion D-dimer value on admission is an accurate biomarker for predicting mortality in patients with COVID-19. 1.5 μg/ml is the optimal cutoff value of admission D-dimer for predicting mortality in COVID-19 patients.

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Neurogranin as a Novel Biomarker in Alzheimer’s Disease

Laboratory Medicine ◽

10.1093/labmed/lmaa062 ◽

2020 ◽

Author(s):

Luisa Agnello ◽

Caterina Maria Gambino ◽

Bruna Lo Sasso ◽

Giulia Bivona ◽

Salvatore Milano ◽

...

Keyword(s):

Operating Characteristic ◽

Neurological Diseases ◽

Area Under The Curve ◽

Curve Analysis ◽

Phosphorylated Tau ◽

Roc Curve Analysis ◽

Total Tau ◽

Novel Biomarkers ◽

Good Diagnostic Accuracy

Abstract Background In this study, we investigated the possible role of 2 novel biomarkers of synaptic damage, namely, neurogranin and α-synuclein, in Alzheimer disease (AD). Methods The study was performed in a cohort consisting of patients with AD and those without AD, including individuals with other neurological diseases. Cerebrospinal fluid (CSF) neurogranin and α-synuclein levels were measured by sensitive enzyme-linked immunosorbent assays (ELISAs). Results We found significantly increased levels of CSF neurogranin and α-synuclein in patients with AD than those without AD. Neurogranin was correlated with total tau (tTau) and phosphorylated tau (pTau), as well as with cognitive decline, in patients with AD. Receiver operating characteristic (ROC) curve analysis showed good diagnostic accuracy of neurogranin for AD at a cutoff point of 306 pg per mL with an area under the curve (AUC) of 0.872 and sensitivity and specificity of 84.2% and 78%, respectively. Conclusions Our findings support the use of CSF neurogranin as a biomarker of synapsis damage in patients with AD.

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A Novel Inflammation-Based Prognostic Score: The Fibrinogen/Albumin Ratio Predicts Prognoses of Patients after Curative Resection for Hepatocellular Carcinoma

Journal of Immunology Research ◽

10.1155/2018/4925498 ◽

2018 ◽

Vol 2018 ◽

pp. 1-11 ◽

Cited By ~ 14

Author(s):

Qiaodong Xu ◽

Yongcong Yan ◽

Songgang Gu ◽

Kai Mao ◽

Jianlong Zhang ◽

...

Keyword(s):

Roc Curve ◽

Prognostic Value ◽

Curative Resection ◽

Operating Characteristic ◽

Curve Analysis ◽

Prognostic Scores ◽

Roc Curve Analysis ◽

Optimal Cutoff ◽

Albumin Ratio ◽

Cutoff Value

Background. Inflammation is an important hallmark of cancer. Fibrinogen and albumin are both vital factors in systemic inflammation. This study investigated the prognostic value of the fibrinogen/albumin ratio in HCC patients who underwent curative resection. Methods. HCC patients (n=151) who underwent curative resection were evaluated retrospectively. The optimal cutoff value for the fibrinogen/albumin ratio was selected by receiver operating characteristic (ROC) curve analysis. Correlations between preoperative fibrinogen/albumin ratios and clinicopathologic characteristics were analyzed by χ2 test. The area under the receiver operating characteristic curve (AUC) was calculated to compare the prognostic value of the fibrinogen/albumin ratio with other prognostic scores (neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and albumin-bilirubin (ALBI) score). The overall survival (OS) and time to recurrence (TTR) were assessed by the log-rank test and the Cox proportional hazard regression model. Results. An optimal cutoff value of the preoperative fibrinogen/albumin ratio (0.062) was determined for 151 patients who underwent curative resection for HCC via a ROC curve analysis. Fibrinogen/albumin ratio > 0.062 was significantly associated with microvascular invasion, an advanced BCLC stage, and ALBI grade. Multivariate analyses revealed that fibrinogen/albumin ratio was an independent predictor for OS (P=0.003) and TTR (P=0.035). The prognostic ability of fibrinogen/albumin ratio was comparable to other prognostic scores (NLR, PLR, and ALBI score) by AUC analysis. Patients with a fibrinogen/albumin ratio > 0.062 had lower 1-, 3-, and 5-year OS rates (66.0%, 41.8%, and 28.2% versus 81.9%, 69.3%, and 56.1%, resp., P<0.001) and higher 1-, 3-, and 5-year recurrence rates (60.9%, 79.2%, and 90.5% versus 49.5%, 69.1%, and 77.1%, resp., P=0.008) compared with patients with fibrinogen/albumin ratio ≤ 0.062. Conclusion. The preoperative fibrinogen/albumin ratio is an effective prognostic factor for HCC patients who underwent curative resection. An elevated fibrinogen/albumin ratio significantly correlates with poorer survival and a higher risk of recurrence in HCC patients.

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Posaconazole Plasma Concentrations on Days Three to Five Predict Steady-State Levels

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.00389-16 ◽

2016 ◽

Vol 60 (9) ◽

pp. 5595-5599 ◽

Cited By ~ 13

Author(s):

Jürgen Prattes ◽

Wiebke Duettmann ◽

Martin Hoenigl

Keyword(s):

Steady State ◽

Operating Characteristic ◽

Hematological Malignancies ◽

Fungal Infections ◽

Plasma Concentrations ◽

Area Under The Curve ◽

Oral Solution ◽

Curve Analysis ◽

Roc Curve Analysis ◽

Steady State Levels

ABSTRACTLow posaconazole plasma concentrations (PPCs) have been associated with breakthrough invasive fungal infections. We assessed the correlation between pre-steady-state PPCs (obtained between days 3 and 5) and PPCs obtained during steady state in 48 patients with underlying hematological malignancies receiving posaconazole oral-solution prophylaxis. Pre-steady-state PPCs correlated significantly with PPCs obtained at steady state (Spearmanr= 0.754;P< 0.001). Receiver operating characteristic (ROC) curve analysis of pre-steady-state PPCs revealed an area under the curve (AUC) of 0.884 (95% confidence interval [CI], 0.790 to 0.977) for predicting satisfactory PPCs at steady state.

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SAT-086 Pituitary Volume as a Diagnostic Measure for Determining the Etiology of Short Stature in Children: Receiver Operating Characteristic Curve Analysis and Cutoff Values

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.106 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Liam McGuirk ◽

Tara P Patale ◽

Nicholas Andrew Krasnow ◽

Alice Alexandrov ◽

James Haigney ◽

...

Keyword(s):

Short Stature ◽

Standard Error ◽

Characteristic Curve ◽

Area Under The Curve ◽

Curve Analysis ◽

Youden Index ◽

Pediatric Endocrinology ◽

Roc Curve Analysis ◽

Gh Secretion ◽

Cutoff Values

Abstract Background: It is speculated that pituitary volume (PV) is a marker of chronic growth hormone (GH) secretion. In previous studies, we determined that children with GH deficiency (GHD) and idiopathic short stature (ISS) had significantly smaller PVs than normal controls (NCs). Cutoff values for small PVs are needed to improve the clinical utility of PV in determining children who qualify for GH therapy. Objective: To define the cutoff between pathologic and nonpathologic PV in prepubertal and pubertal children with short stature (SS). Patients and Methods: The SS group was selected from the database of a pediatric endocrinology center, which was queried for siblings (SBs) aged 6–18 yrs who underwent a GH stimulation test and MRI between 2013–2019. All 77 SBs had SS, defined as 2 SDs below mean height for age, subnormal growth velocity for at least 6 months, or predicted height at least 2 inches discrepant from midparental height. The NC group was selected from the database of a neuroradiology center; these NCs consisted of 170 randomly selected subjects aged 6–18 yrs. Patients with MRI abnormalities were excluded. PVs were calculated using the ellipsoid formula (LxWxH/2). ROC curve analysis was utilized to generate cutoff values. The diagnosis of short stature was the dependent variable and PV was the independent variable. The PV with the highest Youden index was selected as the definitive cutoff for a small PV. Results: The mean (MN) and median (MD) age of SBs was 11.6 ±2.2 and 11.9 yrs, respectively, and the MN and MD age of the NCs was 12.6 ±3.4 and 13.2 yrs, respectively. The MN and MD age of prepubertal SBs (n=29) and NCs (n=58) were 9.3 ±1.2 and 9.7, and 8.6 ±1.4 and 8.6 yrs, respectively. The MN and MD age of pubertal SBs (n=48) and NCs (n=112) were 13.0 ±1.4 and 12.7, and 14.7 ±1.9 and 14.6 yrs, respectively. The difference in MN age between SBs and NCs was significant (p<0.05). For prepubertal subjects, sensitivity was 86.21% and specificity was 68.97%. The distance to corner was 0.3396, and the highest Youden index was 0.5517, corresponding to a PV of 215.02 mm3. The Area Under the Curve (AUC) was 0.8395 with a standard error of 0.0426 (p<0.001). For pubertal subjects, sensitivity was 81.25% and specificity was 79.46%. The distance to corner was 0.2781, and the highest Youden index was 0.6071, corresponding to a PV of 315.0 mm3. The AUC was 0.8460 with a standard error of 0.0337 (p<0.001). Conclusion: To our knowledge, we present the first study on the sensitivity and specificity of PV in determining the etiology of SS. Our data suggest that prepubertal patients with a PV<215.02 mm3 and pubertal patients with a PV<315.00 mm3 have small pituitary glands. Statistically calculated cutoffs are necessary to accurately diagnose pituitary hypoplasia and should be utilized to determine the etiology of SS. Future studies should include children with Tanner staging and height SDs to generate more accurate PV cutoffs.

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Excessive Hormones Concentration in Serum May Increase the Risk of Polyspermy for Single Oocyte

10.21203/rs.3.rs-136349/v1 ◽

2020 ◽

Author(s):

Haijing Zhao ◽

Qi Qiu ◽

Ping Yuan ◽

Nengyong Ouyang ◽

Yuqin Zhu ◽

...

Keyword(s):

Body Mass Index ◽

Follicle Stimulating Hormone ◽

Curve Analysis ◽

Roc Curve Analysis ◽

Optimal Cutoff ◽

Serum Hormones ◽

Female Age ◽

Cutoff Value ◽

Baseline Characteristics ◽

First Time

Abstract Background: Fertilization of an oocyte by multiple sperms is known as polyspermy. Here, the purpose of this work was to investigate the possible correlation between hormones concentration in serum and the fertilization outcome of single oocyte in IVF cycles.Methods: In this retrospective analysis, the baseline characteristics and serum hormones levels of female patients retrieving single oocyte in IVF cycles were analyzed. Female age, duration of infertility, body mass index (BMI), basal follicle stimulating hormone (FSH), basal luteinizing hormone (LH), basal estradiol (E2), the level of FSH, LH, E2 and progesterone (P) on the day of Gonadotropin (Gn), the level of FSH, LH, E2 and P on the day of human chorionic gonadotropin (HCG) were measured. Results: According to the number of pronucleus in single oocyte on Day1, patients were assigned to IVF-2PN group (two pronucleus) and IVF-3PN group (three or more pronucleus). There were extremely higher levels of basal E2, LH and E2 on the day of Gn in IVF-3PN group compared with IVF-2PN group (P<0.01). The significantly higher level of LH on the day of HCG was present in IVF-3PN compared to IVF-2PN group (P<0.05). Forthermore, the optimal cutoff value of basal E2 (70.5 IU/L), LH (6.315 IU/L) and E2 (128.5 IU/L) on the day of Gn and LH (3.28 IU/L) on the day of HCG were determined by ROC curve analysis. The results showed that the percentage of IVF-2PN significantly decreased and the percentage of IVF-3PN considerably increased when the basal E2 concentration was higher than the cutoff value (P<0.05), the same tendency were present in the analysis of LH concentration, E2 concentration on the day of Gn and LH concentration on the day of HCG (P<0.01). Conclusions: Our data indicated for the first time that the excessive concentration of basal E2, excessive concentrations of LH and E2 on the day of Gn and excessive concentration of LH on the day of HCG may significantly increase the risk of polyspermy for single oocyte in IVF cycles.

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Abstract 19569: High-sensitive Troponin T Cut-off Value for Myocardial Infarction After Vascular Surgery

Circulation ◽

10.1161/circ.130.suppl_2.19569 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Danielle M Gualandro ◽

Gisela B Llobet ◽

Pai C Yu ◽

Daniela Calderaro ◽

Andre C Marques ◽

...

Keyword(s):

Myocardial Infarction ◽

Vascular Surgery ◽

Roc Curve ◽

Troponin T ◽

Curve Analysis ◽

Operating Characteristics ◽

Roc Curve Analysis ◽

Cutoff Value ◽

Coronary Syndrome ◽

High Sensitive Troponin

Introduction: Isolated high sensitive cardiac troponin T (hsTnT) elevations after vascular surgery are frequent and may lead to over diagnosis of myocardial infarction (MI). The aim of our study was to determine the accuracy of the current hsTnT cut-off value in the setting of acute coronary syndrome (ACS) after vascular surgery. Methods: Between August 2012 and March 2014, we included 337 consecutive patients submitted to arterial vascular surgery for which cardiac perioperative evaluation was requested. Perioperative surveillance included 12-lead electrocardiogram and hsTnT measurements on the three days following surgery. Patients were followed-up by cardiologists until hospital discharge and monitored for ACS. A receiver operating characteristics (ROC) curve analysis was performed to determine the hsTnT cut-off value with better accuracy for the diagnosis of perioperative ACS. Results: Of the 337 patients included, 240 (71.2%) presented hsTnT elevation above the manufacturer-provided cut-off value (0.014 ng/ml), whereas 22 (6.5%) fulfilled criteria for ACS. Median post-operative peak hsTnT of ACS patients were 0.215 ng/ml (IQR 0.043-0.493 ng/ml), versus 0.02 ng/ml (IQR 0.012-0.038 ng/ml) in patients that did not have events (P<0.001). After performing a ROC curve analysis (AUC = 0.876), we found that the manufacture-provided cutoff hsTnT value yielded a sensitivity of 100% and specificity of only 35% for diagnosis of perioperative ACS. A new hsTnT cutoff value of 0.0415 ng/ml was obtained with 86.4% sensitivity and 77% specificity for the diagnosis of perioperative ACS. Ninety-two patients (27.3%) had hsTnT elevations above the proposed new cutoff. Conclusion: A different hsTnT cutoff value of 0.0415 ng/ml is proposed and could be more useful for the diagnosis of perioperative ACS.

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