What question did this study set out to answer?

To assess the diagnostic utility and kinetic changes of high-sensitivity cardiac troponin T (hs-TnT) for early detection of acute myocardial infarction compared with conventional troponin assays.

January 19, 2015The Egyptian Heart JournalOpen Access

The diagnostic utility of High-Sensitivity Cardiac Troponin T in acute coronary syndrome

View Full Paper

Ask AI

Bookmark

Why the study?

Does High-Sensitivity Cardiac Troponin T improve the early detection of acute myocardial infarction compared to conventional troponin assays in patients with suspected acute coronary syndrome?

Key Points

To assess the diagnostic utility and kinetic changes of high-sensitivity cardiac troponin T (hs-TnT) for early detection of acute myocardial infarction compared with conventional troponin assays.
Recruited 60 subjects: 10 healthy controls and 50 emergency department patients presenting with chest pain suspicious for acute cardiac ischemia, non-specific ECG changes, and baseline conventional cardiac troponin I <100 ng/L.
Stratified patients at admission by hs-TnT into subgroup A (<14 ng/L, n=16) and subgroup B (≥14 ng/L, n=34), with 6–8 hour repeat testing performed for subgroup B and one high-suspicion subgroup A patient.
Reclassified patients after confirmatory cardiological evaluation into unstable angina (n=17) and non-ST-elevation myocardial infarction (NSTEMI, n=33).
At a cutoff of 4.8 ng/L, hs-TnT distinguished acute coronary syndrome patients from healthy controls with 96% sensitivity, 100% specificity, 100% PPV, 83.3% NPV, and 96.7% overall diagnostic efficiency.
At a cutoff of 13.7 ng/L, hs-TnT differentiated NSTEMI from unstable angina with 97% sensitivity, 88.2% specificity, 94.1% PPV, 93.8% NPV, and 94% diagnostic efficiency.
Baseline hs-TnT detected 97% of myocardial infarction cases with initially negative conventional troponin I, and reached 100% detection after 6–8 hours compared with only 21.2% detected by conventional troponin I.

Structured PICO

Does High-Sensitivity Cardiac Troponin T improve the early detection of acute myocardial infarction compared to conventional troponin assays in patients with suspected acute coronary syndrome?

Population

60 subjects: 50 patients presenting to the emergency department with chest pain highly suspicious for acute cardiac ischemia, having no or non-specific ECG changes, and admission Cardiac Troponin I level < 100 ng/L, plus 10 healthy controls.

Intervention

High-Sensitivity Cardiac Troponin T (hs-TnT) assay measured on admission and at 6-8 hours

Comparator

Conventional Cardiac Troponin I assay

Outcome

Diagnostic performance (sensitivity, specificity, PPV, NPV, and efficiency) for early detection of acute myocardial infarction and discrimination of NSTEMI from unstable anginasurrogate

High-sensitivity cardiac troponin T provides excellent diagnostic accuracy for the early detection of NSTEMI in patients presenting with suspected ACS and negative conventional troponin.

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

May aid NSTEMI detection in ACS with negative conventional troponin; leaves open incremental value in prospective validation.

Cite This Study

Mohsen et al. (2015) studied this question.

synapsesocial.com/papers/6a70e39f26a7f98052dd58a9 https://doi.org/10.1016/j.ehj.2014.12.003

View Full Paper

Ask AI

Bookmark

The diagnostic utility of High-Sensitivity Cardiac Troponin T in acute coronary syndrome

Key Points

Structured PICO

Discussion

Implication

Cite This Study

The diagnostic utility of High-Sensitivity Cardiac Troponin T in acute coronary syndrome

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Also Consider