Gender differences in correlates of troponin assay in diagnosis of myocardial infarction
| Autor: | Azadeh Shoaibi, Dale R. Tavris, Steven McNulty |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Male
Chest Pain medicine.medical_specialty Acute coronary syndrome Myocardial Infarction Chest pain Diagnosis Differential Electrocardiography Sex Factors Troponin T Troponin complex Predictive Value of Tests Physiology (medical) Internal medicine Troponin I medicine Humans Prospective Studies Myocardial infarction Renal Insufficiency Chronic Prospective cohort study Heart Failure biology business.industry Biochemistry (medical) Public Health Environmental and Occupational Health Reproducibility of Results General Medicine medicine.disease Troponin biology.protein Cardiology Female Myocardial infarction diagnosis medicine.symptom business Biomarkers |
| Zdroj: | Translational Research. 154:250-256 |
| ISSN: | 1931-5244 |
| Popis: | Cardiac troponins are the most sensitive and specific biomarker for myocardial infarction (MI) diagnosis. If there is a gender bias in MI diagnosis, it could be reduced by more consistently applying objective diagnostic criteria to improve women's outcomes. This study set out to assess the accuracy and correlates of the cardiac troponin I (cTnI) assay in the diagnosis of non-ST-segment elevation MI, to determine how the assay accuracy and correlates vary by gender, and to explore the interaction between factors that may influence cTnI accuracy and affect gender differences in diagnosis. The data were obtained from the CHECKMATE study. It included 924 patients with possible myocardial ischemia excluding subjects with ST-segment elevation. The Dade-Behring Stratus CS STAT near-patient instrument (Dade Behring, Inc, Newark, Del) was used to measure cTnI. We assessed baseline troponin accuracy using a standard MI definition. There were 125 subjects with a definite MI diagnosis. Baseline troponin was 44% sensitive and 97% specific in predicting MI, with no significant gender differences. In contrast, other positive cardiac markers, namely rising or falling creatine-kinase MB fraction and positive electrocardiogram, occurred more frequently in men. Sensitivity (SE) of baseline troponin was higher in subjects where baseline troponin was obtained longer than 2 hours after the chest pain onset. The study did not observe a significant difference in the assay SE or specificity by gender. This observation, plus the fact that other positive cardiac markers occurred more frequently in men, suggest the troponin test may help to improve the diagnosis of MI in women. |
| Databáze: | OpenAIRE |
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