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  • Title: Diagnostic value of high sensitive troponin T in chest pain patients with no persistent ST-elevations.
    Author: Melki D, Lind S, Agewall S, Jernberg T.
    Journal: Scand Cardiovasc J; 2011 Aug; 45(4):198-204. PubMed ID: 21428843.
    Abstract:
    OBJECTIVES: The aim of this study was to compare the early diagnostic value of the Roche high-sensitive troponin T (Hs-TnT) and that of conventional troponins. DESIGN: A total of 233 consecutive chest pain patients without ST-elevations were included. Hs-TnT was compared with two conventional assays (Roche troponin T [fourth generation] and Beckman Coulter Accu-TnI) on admission and at two hours. RESULTS: When acute Myocardial Infarction (MI) was defined by conventional troponins and prespecified decision limits (Hs-TnT ≥ 14 ng/l, conventional TnT ≥ 0.04 μg/l, and Accu-TnI ≥ 0.06 μg/l) were used, Hs-TnT had a higher sensitivity but a lower specificity than conventional troponins both on admission and after two hours. When the biomarkers were compared in a ROC analysis there were no significant differences with regard to AUC. When acute MI was defined by Hs-TnT, the diagnostic performance of Hs-TnT remained very high (on admission: sensitivity 96%, specificity 85%, at two hours: sensitivity 99%, specificity 83%) whereas that of conventional troponins became lower, mainly because of lower sensitivity. CONCLUSION: In conclusion, when acute MI is defined by a high sensitive troponin assay, the use of Hs-TnT improves the early diagnostic accuracy compared with conventional troponins. By measuring Hs-TnT it seems possible to exclude acute MI already within the first few hours from admission.
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