Key result
Cardiac troponin T was as sensitive but less specific than CK-MB for diagnosing AMI, and abnormal levels were associated with a higher risk of adverse cardiac outcomes in non-AMI patients.
Why the study?
Does cardiac troponin T (cTnT) provide comparable diagnostic sensitivity to CK-MB for AMI and prognostic value for adverse outcomes in patients with ischemic heart disease?
Meta-Analysis
Does cardiac troponin T (cTnT) provide comparable diagnostic sensitivity to CK-MB for AMI and prognostic value for adverse outcomes in patients with ischemic heart disease?
This early meta-analysis demonstrates that cardiac troponin T is as sensitive as CK-MB for diagnosing AMI and provides important prognostic information for risk stratification in non-AMI ischemic heart disease patients.
Supports cTnT for AMI diagnosis and non-AMI risk stratification; extends meta-analytic evidence for troponin-based cardiac evaluation.
Metaanalysis is a method that incorporates the pooling of previously published results to produce more statistically significant results. We used metaanalysis to examine the role of a new cardiac marker, cardiac troponin T (cTnT), in patients with ischemic heart disease. Metaanalysis of six articles and one abstract on cTnT showed that this marker was just as sensitive as creatine kinase MB isoenzyme (CK-MB) for the retrospective diagnosis of acute myocardial infarction (AMI) 12-48 h after onset but less specific. Most of these articles showed that cTnT was increased in non-AMI patients with unstable angina pectoris. In a metaanalysis of four papers, two abstracts, a letter, and an unpublished manuscript, we examined the prognostic role of cTnT in non-AMI cardiac patients. For an unfavorable endpoint defined as cardiac death, AMI, or the need for coronary artery revascularization, the results demonstrated that abnormal concentrations of cTnT were associated with a higher risk for a poor outcome than were normal concentrations of cTnT. We also compared cTnT with CK-MB for risk stratification. Metaanalysis will become an increasingly important tool for evaluating new tests as they become available.
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Wu et al. (1995) conducted a meta-analysis in ischemic heart disease. Cardiac troponin T (cTnT) vs. Creatine kinase MB isoenzyme (CK-MB) or normal concentrations of cTnT was evaluated on Retrospective diagnosis of AMI 12-48 h after onset and an unfavorable endpoint defined as cardiac death, AMI, or the need for coronary artery revascularization. Cardiac troponin T was as sensitive but less specific than CK-MB for diagnosing AMI, and abnormal levels were associated with a higher risk of adverse cardiac outcomes in non-AMI patients.
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