Key result
Sensitive cardiac troponin I >0.06 ng/mL provides good discrimination between healthy cats and those with HCM.
Why the study?
Hypertrophic cardiomyopathy is commonly not diagnosed in cats until congestive heart failure, arterial thromboembolism, or sudden cardiac death occurs, creating a need for an affordable screening test for early detection.
Does a sensitive cardiac troponin I assay accurately screen for hypertrophic cardiomyopathy in cats?
Cross-Sectional (n=166)
Does a sensitive cardiac troponin I assay accurately screen for hypertrophic cardiomyopathy in cats?
Effect estimate: AUC 0.95 (95% CI 0.899-0.978)
p-value: p=<0.000001
A sensitive cardiac troponin I assay with a cutoff of >0.06 ng/mL serves as a highly sensitive and specific screening test for hypertrophic cardiomyopathy in cats, though echocardiography remains necessary for confirmation.
May support troponin I screening for feline HCM; leaves open prospective validation before practice change.
Background Hypertrophic cardiomyopathy (HCM) is the most common cardiac disease in cats. However, most cats are not diagnosed until they develop congestive heart failure, arterial thromboembolism (ATE), or sudden cardiac death. Thus, an affordable screening test for early detection of HCM is desirable. Hypothesis/Objectives Evaluation of a sensitive cardiac troponin I (cTnI) assay as a screening test for HCM in cats and determination of a cutoff for its early detection. Animals One hundred sixty-six client-owned cats (male, n = 97) of various breeds were evaluated and classified using echocardiography as being healthy (n = 87), equivocal (n = 15), or having HCM (mild, n = 16; moderate, n = 10; severe, n = 34) or ATE (n = 4). Methods All cats were prospectively evaluated by echocardiography, and serum cTnI concentration was determined using the currently most sensitive assay (Siemens ADVIA Centaur TnI-Ultra). Results The median cTnI concentration was significantly different between study groups (P < .000001). A cutoff of 0.06 ng/mL provided good discrimination between healthy cats and cats with HCM (sensitivity, 91.7%; specificity, 95.4%; area under the curve [AUC], 0.95; 95% confidence interval [CI], 0.899-0.978). Even for asymptomatic cats with HCM, sensitivity and specificity for a cutoff of >0.06 ng/mL remained high at 87.8% and 95.4%, respectively (AUC, 0.93; 95% CI, 0.864-0.964). Conclusions and clinical importance Cardiac troponin I can be used as a sensitive and specific screening test for the diagnosis of HCM in otherwise healthy cats (cutoff, >0.06 ng/mL). However, echocardiography is needed to confirm the diagnosis.
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Hertzsch et al. (2019) conducted a cross-sectional in Hypertrophic cardiomyopathy (HCM) (n=166). Sensitive cardiac troponin I (cTnI) assay vs. Healthy cats was evaluated on Discrimination between healthy cats and cats with HCM (AUC 0.95, 95% CI 0.899-0.978, p=<0.000001). A sensitive cardiac troponin I assay using a cutoff of >0.06 ng/mL provided good discrimination between healthy cats and cats with hypertrophic cardiomyopathy (AUC 0.95; 95% CI 0.899-0.978).
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