Direct comparison of high-sensitivity cardiac troponin T and I in the early differentiation of type 1 vs. type 2 myocardial infarction
Why the study?
To directly compare the diagnostic accuracy of hs-cTnT vs hs-cTnI in the early non-invasive differentiation of T1MI from T2MI.
Does high-sensitivity cardiac troponin T provide comparable diagnostic accuracy to high-sensitivity cardiac troponin I for differentiating type 1 from type 2 myocardial infarction in patients presenting with acute chest pain?
Population
5887 patients presenting with acute chest pain
Comparison
hs-cTnT-Elecsys vs hs-cTnI-Architect assays
Design
Prospective multicentre diagnostic study
Authors
Discussion
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Member takes
Implication
Comparable moderate accuracy of hs-cTnT and hs-cTnI limits reliable early T1MI vs T2MI differentiation; leaves open whether adjunctive markers or algorithms improve performance.
Structured PICO
Does high-sensitivity cardiac troponin T provide comparable diagnostic accuracy to high-sensitivity cardiac troponin I for differentiating type 1 from type 2 myocardial infarction in patients presenting with acute chest pain?
P
Population
5,887 patients presenting with acute chest pain. 1,106 (19%) had a final diagnosis of MI (860 T1MI and 246 T2MI).
I
Intervention
High-sensitivity cardiac troponin T (hs-cTnT-Elecsys) measured at presentation, 1 h, and 2 h
C
Comparator
High-sensitivity cardiac troponin I (hs-cTnI-Architect) measured at presentation, 1 h, and 2 h
O
Outcome
Diagnostic accuracy (AUC) for the early differentiation of Type 1 myocardial infarction (T1MI) from Type 2 myocardial infarction (T2MI)surrogate
Both hs-cTnT and hs-cTnI provide comparable but only moderate diagnostic accuracy for differentiating type 1 from type 2 myocardial infarction early after presentation.
Cite This Study
Nestelberger et al. (2021) studied this question.