Validation and correlation of high-sensitive troponin I and troponin T in the emergency department.

Autor: Nseir M; Department of Internal and Emergency Medicine, Trelleborg Hospital, Trelleborg, Sweden., Mokhtari A; Department of Cardiology, Lund University, Skåne University Hospital, Entrégatan 7, Lund, 221 85, Sweden.; Lund University, Department of Clinical Sciences, Lund, Sweden., Stanisic M; Department of Internal and Emergency Medicine, Trelleborg Hospital, Trelleborg, Sweden., Ekström U; Department of Clinical Chemistry, Lund University, Skåne University Hospital, Lund, Sweden., Labaf A; Department of Cardiology, Lund University, Skåne University Hospital, Entrégatan 7, Lund, 221 85, Sweden. ashkan.labaf@med.lu.se.; Lund University, Department of Clinical Sciences, Lund, Sweden. ashkan.labaf@med.lu.se.
Jazyk: angličtina
Zdroj: BMC cardiovascular disorders [BMC Cardiovasc Disord] 2024 Oct 12; Vol. 24 (1), pp. 551. Date of Electronic Publication: 2024 Oct 12.
DOI: 10.1186/s12872-024-04230-1
Abstrakt: Background: Troponin elevation is frequently observed in various scenarios in the Emergency Department (ED), yet there is a paucity of studies investigating simultaneously measured high-sensitivity cardiac troponin T (hs-cTnT) and troponin I (hs-cTnI) within a diverse cohort in a clinical setting.
Methods: All patients who underwent troponin testing at a single center were eligible for this study. Only patients with simultaneous samples with hs-cTnI (Siemens) and hs-cTnT (Roche) were included, regardless of chief complaint.
Results: Analysis of 1987 samples from 1134 patients showed a significant correlation between hs-cTnT and hs-cTnI (r = 0.86, p < 0.01). Of these samples, 65% exceeded the upper reference limit (URL) for hs-cTnT, and 30% for hs-cTnI with 39% who exhibited elevated hs-cTnT levels alongside normal hs-cTnI levels. The area under the curve (AUC) for acute myocardial infarction (AMI) for the index visit was 0.80 (95% CI; 0.75-0.85) for hs-cTnT and 0.87 (95% CI; 0.83-0.91) for hs-cTnI. Sensitivity and specificity were 91% and 39% for hs-cTnT, and 80% and 80% for hs-cTnI. Positive predictive value (PPV) and negative predictive value (NPV) was 9.3% and 98.5% for hs-cTnT respectively, corresponding for hs-cTnI was 21.3% and 98.3% respectively. Hazard ratios for 1-year mortality were 1.52 (95% CI; 1.40-1.66) for hs-cTnT and 1.26 (95% CI; 1.18-1.34) for hs-cTnI.
Conclusion: Elevated troponins above the URL were very common in this diverse cohort, particularly for hs-cTnT, which was twice as frequent compared to hs-cTnI, resulting in low specificity and PPV for AMI.
(© 2024. The Author(s).)
Databáze: MEDLINE
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