Assessment of the Multiple-Biomarker Approach for Diagnosis of Myocardial Infarction in Patients Presenting with Symptoms Suggestive of Acute Coronary Syndrome
Key result
Cardiac troponin I alone (sensitivity 72%, specificity 89%) was more clinically accurate for early diagnosis of MI than a multiple-biomarker approach, which reduced sensitivity.
Why the study?
Does a multiple-biomarker approach improve diagnostic accuracy for myocardial infarction compared to cardiac troponin I alone in patients with suspected acute coronary syndrome?
Population
457 patients presenting on admission with symptoms suggestive of acute coronary syndrome, of which 25…
Comparison
Multiple-biomarker approach vs Cardiac troponin I (cTnI) alone
Design
Cross-sectional
Authors
Discussion
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Member takes
Implication
Troponin I alone may suffice for early MI diagnosis in suspected ACS; hypothesis-generating and requires prospective validation before practice change.
Study Design
Type
Observational (n=457)
Structured PICO
Does a multiple-biomarker approach improve diagnostic accuracy for myocardial infarction compared to cardiac troponin I alone in patients with suspected acute coronary syndrome?
P
Population
457 patients presenting on admission with symptoms suggestive of acute coronary syndrome, of whom 5.4% received MI diagnoses.
E
Exposure
Multiple-biomarker approach (myeloperoxidase, soluble CD40 ligand, placental growth factor, matrix metalloproteinase 9 [MMP-9], high-sensitivity C-reactive protein [hsCRP], cardiac troponin I [cTnI], N-terminal pro-B-type natriuretic peptide, and estimated glomerular filtration rate)
C
Comparator
Cardiac troponin I (cTnI) alone
O
Outcome
Diagnostic accuracy (sensitivity and specificity) for detecting myocardial infarctionsurrogate
A multiple-biomarker approach does not improve the early diagnosis of myocardial infarction compared to an analytically robust cardiac troponin I assay alone.
Cite This Study
Smith et al. (2008) conducted an observational in Symptoms suggestive of acute coronary syndrome (n=457). Multiple-biomarker approach vs. Cardiac troponin I (cTnI) alone was evaluated on Diagnosis of myocardial infarction. Cardiac troponin I alone (sensitivity 72%, specificity 89%) was more clinically accurate for early diagnosis of MI than a multiple-biomarker approach, which reduced sensitivity.