Comparison of the new high sensitive cardiac troponin T with myoglobin, h-FABP and cTnT for early identification of myocardial necrosis in the acute coronary syndrome
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Kerstin Kurz Evangelos Giannitsis Maike Becker Georg Hess Dietmar Zdunek Hugo A. Katus
- چاپ و سال / کشور: 2010
Description
Background We sought to determine the performance of the new high sensitivity cardiac troponin T assay (TnThs) for early diagnosis of myocardial infarction in patients with suspected acute coronary syndrome (ACS) and compare it with the fourth generation cTnT assay, myoglobin and heart-type fatty acid binding protein (h-FABP). Methods Ninety-four patients with diagnosis of suspected ACS without ST-segment elevation admitted to our chest pain unit were included. Patients were divided according to time from onset of symptoms to presentation into an early presenter group (\4 h) and a late presenter group (C4 h). A median of six samples (range 2–8) were available per patient. The diagnostic performance of TnThs was assessed using ROC analysis. Areas under the curve (AUC) of baseline and follow-up results of TnThs, cTnT, myoglobin, and h-FABP were compared using c statistics. Results The TnThs assay allows an excellent prediction of non-ST-segment elevation myocardial infarction (non- STEMI) at presentation, particularly among late presenters. A follow-up sample improves diagnostic performance in a time-dependent manner. The AUC of TnThs was superior to cTnT at all time points. The performance of TnThs was at least as good as myoglobin and h-FABP at presentation and during follow-up. Conclusions A baseline sample of TnThs allows an earlier prediction of non-STEMI than the less sensitive and precise fourth generation cTnT assay. Probably, this excellent performance of TnThs at baseline and follow-up could obviate the need for other early markers of necrosis in future.
Clin Res Cardiol (2011) 100:209–215 DOI 10.1007/s00392-010-0230-y Received: 26 April 2010 / Accepted: 7 September 2010 / Published online: 18 September 2010
