Key result
Siemens Vista cTnI best predicts MI while extreme hs-cTnT predicts ~88-fold higher cardiovascular mortality.
Why the study?
Guidelines do not differentiate between available cardiac troponin assays, so the study compared their prognostic and predictive ability.
Does the choice of cardiac troponin assay affect the predictive and prognostic accuracy for myocardial infarction and mortality in patients with acute coronary syndrome?
Population
90 705 ACS patients with ≥ 2 cTn measurements from Danish registries
Comparison
Roche hs-cTnT vs Abbott hs-cTnI vs Siemens Vista cTnI vs Siemens cTnI Ultra
Design
Nationwide register-based cohort study
Follow-up
1 year
Authors
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May inform assay selection for MI versus mortality prediction in ACS; leaves open impact on management.
Cohort (n=90,705)
Yes
Does the choice of cardiac troponin assay affect the predictive and prognostic accuracy for myocardial infarction and mortality in patients with acute coronary syndrome?
Effect estimate: AUC 0.93 (95% CI 0.93-0.93)
Different cardiac troponin assays have varying predictive and prognostic abilities, with Siemens Vista cTnI best predicting MI and hs-cTnT best predicting mortality in ACS patients.
Hasselbalch et al. (2022) conducted a cohort in acute coronary syndrome (ACS) (n=90,705). Cardiac troponin assays (Roche hs-cTnT, Abbott hs-cTnI, Siemens Vista cTnI, Siemens cTnI Ultra) vs. Comparison between assays was evaluated on Myocardial infarction (MI) during admission (AUC 0.93, 95% CI 0.93-0.93). Siemens Vista cTnI was the strongest predictor of MI (AUC 0.93), while hs-cTnT was the strongest predictor of cardiovascular mortality (OR 88.8 for concentrations >100 times the 99th percentile).
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