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Scand Cardiovasc J. 2011 Aug;45(4):198-204. doi: 10.3109/14017431.2011.565792. Epub 2011 Mar 24.

Diagnostic value of high sensitive troponin T in chest pain patients with no persistent ST-elevations.

Author information

1
Section of Cardiology, Department of Medicine, Karolinska University Hospital, Huddinge Karolinska Institutet, Stockholm, Sweden. Dina.Melki@karolinska.se

Erratum in

  • Scand Cardiovasc J. 2011 Aug;45(4):204.

Abstract

OBJECTIVES:

The aim of this study was to compare the early diagnostic value of the Roche high-sensitive troponin T (Hs-TnT) and that of conventional troponins.

DESIGN:

A total of 233 consecutive chest pain patients without ST-elevations were included. Hs-TnT was compared with two conventional assays (Roche troponin T [fourth generation] and Beckman Coulter Accu-TnI) on admission and at two hours.

RESULTS:

When acute Myocardial Infarction (MI) was defined by conventional troponins and prespecified decision limits (Hs-TnT ≥ 14 ng/l, conventional TnT ≥ 0.04 μg/l, and Accu-TnI ≥ 0.06 μg/l) were used, Hs-TnT had a higher sensitivity but a lower specificity than conventional troponins both on admission and after two hours. When the biomarkers were compared in a ROC analysis there were no significant differences with regard to AUC. When acute MI was defined by Hs-TnT, the diagnostic performance of Hs-TnT remained very high (on admission: sensitivity 96%, specificity 85%, at two hours: sensitivity 99%, specificity 83%) whereas that of conventional troponins became lower, mainly because of lower sensitivity.

CONCLUSION:

In conclusion, when acute MI is defined by a high sensitive troponin assay, the use of Hs-TnT improves the early diagnostic accuracy compared with conventional troponins. By measuring Hs-TnT it seems possible to exclude acute MI already within the first few hours from admission.

PMID:
21428843
DOI:
10.3109/14017431.2011.565792
[Indexed for MEDLINE]

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