Key result
Cardiac troponin I testing detected acute myocardial infarction in 79% of patients at admission compared to 43.5% for CK-MB, with overall peak sensitivity of 97% and specificity of 98%.
Why the study?
Does cardiac troponin I (TnI) testing improve the diagnosis of acute myocardial infarction compared to CK-MB in patients presenting to the emergency department with chest pain?
Observational (n=316)
Does cardiac troponin I (TnI) testing improve the diagnosis of acute myocardial infarction compared to CK-MB in patients presenting to the emergency department with chest pain?
Cardiac troponin I demonstrates superior diagnostic performance compared to CK-MB for the early detection of acute myocardial infarction in emergency department patients with chest pain.
May support TnI over CK-MB for early AMI diagnosis in ED chest pain; leaves open outcome impact in prospective trials.
Cardiac troponin I (TnI) was tested in 316 consecutive patients with chest pain who were admitted to the emergency department, of whom 62 were discharged with a diagnosis of acute myocardial infarction (AMI). The TnI level was abnormal in 49 patients with AMI compared with 27 for creatine kinase (CK)-MB in the first specimen obtained at admission. All 62 patients with AMI were correctly diagnosed at admission with a combination of TnI and myoglobin testing. The overall peak performance of TnI testing in samples received within 24 hours of admission indicated high sensitivity (97%) and specificity (98%) for the diagnosis of AMI. The TnI was positive in elderly patients with myocardial injury and low CK and normal CK-MB values. These data suggest that testing for TnI could replace CK-MB and, in combination with myoglobin, could facilitate the rapid and effective triage of patients with chest pain in the emergency department.
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D’Costa et al. (1997) conducted an observational in Acute myocardial infarction (n=316). Cardiac troponin I (TnI) testing vs. Creatine kinase (CK)-MB testing was evaluated on Abnormal test result in the first specimen obtained at admission in patients with acute myocardial infarction. Cardiac troponin I testing detected acute myocardial infarction in 79% of patients at admission compared to 43.5% for CK-MB, with overall peak sensitivity of 97% and specificity of 98%.
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