'Real life use' of troponin in the emergency department: a survey of over 3000 cases

Autor: Francesca Santi, Alessia Puma, Giorgio Bellomo, Matteo Vidali, Enrica Verzotti, Nicole Cabraz, Gian Carlo Avanzi, Giuseppe Lippi, Alessandro Lupi
Jazyk: angličtina
Rok vydání: 2015
Předmět:
Male
Clinical Biochemistry
Coronary Angiography
Chest pain
Electrocardiography
Patient Admission
Risk Factors
Troponin I
Medicine
Single-Blind Method
hospital
troponin I
acute coronary syndrome
emergency service
hospital
chest pain
Hematologic Tests
biology
medicine.diagnostic_test
Age Factors
musculoskeletal system
Italy
Cardiovascular Diseases
Predictive value of tests
Cardiology
Population study
Female
medicine.symptom
Research Article
medicine.medical_specialty
Acute coronary syndrome
Digestive System Diseases
macromolecular substances
Sensitivity and Specificity
Diagnosis
Differential
Predictive Value of Tests
Internal medicine
Diabetes Mellitus
Humans
Aged
Retrospective Studies
emergency service
business.industry
Biochemistry (medical)
Emergency department
Respiration Disorders
medicine.disease
Troponin
biology.protein
business
Zdroj: Biochemia Medica
Volume 25
Issue 3
ISSN: 1330-0962
1846-7482
Popis: Introduction The aim of this study was to identify clinical variables which may be independently associated with positivity of a cardiac troponin I (cTnI) assay in a large population of patients admitted to the emergency department (ED). Materials and methods 3166 subjects, with at least two troponin I tests ordered within 6 hours in the ED, were studied. Patient data were statistically analyzed to identify clinical associations with increased values of Troponin I. Results Although patients with diagnosis of acute coronary syndrome displayed troponin I values significantly higher than those of other groups, positivity to troponin I (>40 ng/L) was also observed in patients with other clinical conditions. In multivariate analysis, age, elevated heart rate and electrocardiographic changes were independently associated with troponin I positivity at admission. In the whole study population troponin I positivity exhibited high sensitivity and negative predictive value, counterbalanced by low specificity and limited positive predictive value. Conclusions Troponin I positivity should be combined with history and clinical evaluation and cautiously interpreted in the ED, especially in patients exhibiting factors associated with higher troponin I levels such as older age, elevated heart rate or ECG changes.
Databáze: OpenAIRE
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