Format

Send to

Choose Destination
Korean J Lab Med. 2011 Jul;31(3):172-8. doi: 10.3343/kjlm.2011.31.3.172. Epub 2011 Jun 28.

Diagnostic performance of high-sensitivity troponin T, myeloperoxidase, and pregnancy-associated plasma protein A assays for triage of patients with acute myocardial infarction.

Author information

1
Department of Pathology, Army Medical College National University of Sciences and Technology, Islamabad, Pakistan. dakhan@cpsp.edu.pk

Abstract

BACKGROUND:

Early diagnosis is the cornerstone of management of acute myocardial infarction (AMI). We aimed to compare the diagnostic accuracy of high-sensitivity troponin T (hs-cTnT) with myeloperoxidase (MPO) and pregnancy-associated plasma protein A (PAPP-A) for early diagnosis of AMI in patients at the time of presentation to the emergency department (ED).

METHODS:

We enrolled 289 patients who presented at the ED of the National Institute of Heart Disease (NIHD) Rawalpindi, Pakistan, within 4 hr of onset of chest pain. Clinical assessment, electrocardiography (ECG), and angiography were carried out. Blood samples were collected at 0, 3, 6, and 12 hr. Analyses of plasma hs-cTnT, MPO, and PAPP-A were carried out using commercial kits.

RESULTS:

Out of 289 subjects who presented to the ED, we diagnosed 180 patients with coronary heart disease as having AMI (N= 61) and 119 as without AMI (stable coronary artery disease, N=61; unstable angina, N=58). Compared to non-AMI patients, the patients with AMI had significantly higher levels (represented here as median [inter quartile range]) of plasma hs-cTnT (136 [39-370] vs. 12 [7-21] ng/L), MPO (906 [564-1,631] vs. 786 [351-1,299] pmol/L) and PAPP-A (5.78 [2.67-13.4] vs. 2.8 [1.8-4.9] mIU/L). Receiver operator characteristic curves (95% CI) for hs-cTnT (0.952 [0.909-0.978]) were significantly higher (P<0.001) than those for MPO (0.886 [0.830-0.929]) and PAPP-A (0.797 [0.730-0.854]), with AMI sensitivity and specificity percentages of 87% and 98% (hs-cTnT), 82% and 84% (MPO), and 65% and 87% (PAPP-A), respectively.

CONCLUSIONS:

The diagnostic performance of hs-cTnT was superior to that of MPO and PAPP-A for early triage and diagnosis of AMI among patients of coronary heart disease presenting with chest pain to the ED.

KEYWORDS:

Acute myocardial infarction; Diagnostic accuracy; High-sensitivity troponin T; Myeloperoxidase; Pregnancy-associated plasma protein A

PMID:
21779191
PMCID:
PMC3129348
DOI:
10.3343/kjlm.2011.31.3.172
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for The Korean Society for Laboratory Medicine Icon for PubMed Central
Loading ...
Support Center