What is the clinical evidence from this study?

Study design: Editorial. Population: Acute myocardial infarction. Intervention: Delta cardiac troponin values vs. Single measurement.

November 29, 2011Clinical ChemistryOpen Access

Delta Cardiac Troponin Values in Practice: Are We Ready to Move Absolutely Forward to Clinical Routine?

View Full Paper

Ask AI

Bookmark

Key result

Diagnostic algorithms using absolute delta cardiac troponin values over short time periods improve diagnostic specificity for acute myocardial infarction, though assay-specific cutoffs are required.

Why the study?

Does an absolute delta in high-sensitivity cardiac troponin T improve diagnostic accuracy for acute myocardial infarction compared to relative delta or single peak values in patients with suspected ACS?

Structured PICO

Population

Patients with definite acute coronary syndrome (ACS) and those with an increased hs-cTnT result unrelated to ACS (excluding patients without ACS and with hs-cTnT <99th percentile)

Exposure

Absolute delta (change) in high-sensitivity cardiac troponin T (hs-cTnT) over 6 hours

Comparator

Relative (percentage) delta in hs-cTnT or single peak hs-cTnT value

Outcome

Diagnostic accuracy (sensitivity and specificity) for acute myocardial infarction (AMI)surrogate

Limitations

Each individual cardiac troponin assay requires a specific delta determination.
Different cutoffs for different studied populations will be confusing to clinicians.
Biological variation influences optimal absolute and percentage delta values.
Potential bias when the biomarker method being studied also contributes to the gold standard diagnosis.
Different delta cutoffs for different studied populations will be confusing.
Deliberate selection of patients without ACS and with hs-cTnT >14 ng/L is not representative of broader emergency department patients.
Potential bias because the diagnostic gold standard included a 20% relative change obtained later than 6 h.
Unclear whether delta values included both increasing and decreasing changes.

Discussion

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

Implication

Absolute changes in high-sensitivity cardiac troponin over short time intervals may improve diagnostic specificity for acute myocardial infarction, but assay-specific criteria and broader validation are required before routine clinical implementation.

Cite This Study

Apple et al. (2011) conducted an editorial in Acute myocardial infarction. Delta cardiac troponin values vs. Single measurement was evaluated. Diagnostic algorithms using absolute delta cardiac troponin values over short time periods improve diagnostic specificity for acute myocardial infarction, though assay-specific cutoffs are required.

synapsesocial.com/papers/6a7721780c6965f1a01e97ae https://doi.org/10.1373/clinchem.2011.175414

View Full Paper

Ask AI

Bookmark

Delta Cardiac Troponin Values in Practice: Are We Ready to Move Absolutely Forward to Clinical Routine?

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Delta Cardiac Troponin Values in Practice: Are We Ready to Move Absolutely Forward to Clinical Routine?

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Keep reading

Keep reading