High-sensitive cardiac troponin T outperforms novel diagnostic biomarkers in patients with acute chest pain
2012 (English)In: Clinica Chimica Acta, ISSN 0009-8981, E-ISSN 1873-3492, Vol. 413, no 13-14, 1135-1140 p.Article in journal (Refereed) Published
Background: Measurement of high-sensitive cardiac troponin (hs-cTn) has facilitated the early diagnostic assessment of chest pain patients. However, the information obtained from hs-cTnT levels might be improved when combined with results of other biomarkers of myocardial injury.
Methods: We measured admission levels of hs-cTnT (Roche Diagnostics), heart-type fatty-acid binding protein (H-FABP; Randox Laboratories) and copeptin using a novel ultra-sensitive (us) assay (Thermo Fisher Scientific) in 360 chest pain patients with a non-diagnostic ECG. Non-STEMI was defined according to the Universal Definition using cardiac troponin I (Stratus CS; Siemens Healthcare Diagnostics) as biochemical gold standard.
Results: Non-STEMI was diagnosed in 128 (36%) patients. Hs-cTnT had a greater diagnostic accuracy regarding non-STEMI (C-statistics 0.84) compared to H-FABP (C-statistics 0.80; p = 0.04) and us-copeptin C-statistics(0.62; p < 0.001). Compared to hs-cTnT alone, no increase in the C-statistics was noted for the combination of hs-cTnT with H-FABP (0.85; p = 0.43) or with us-copeptin (0.84; p = 0.88). Due to suboptimal sensitivities and/or specificities, neither H-FABP nor us-copeptin dichotomized at commonly applied diagnostic thresholds added information to hs-cTnT that would have facilitated early diagnostic assessment.
Conclusions: Hs-cTnT provides an excellent early diagnostic accuracy regarding non-STEMI already on admission. Neither H-FABP nor us-copeptin perform better or provide diagnostic increment to hs-cTnT levels.
Place, publisher, year, edition, pages
2012. Vol. 413, no 13-14, 1135-1140 p.
High-sensitive cardiac troponin T, Heart-type fatty acid-binding protein, Copeptin, Chest pain, Myocardial infarction
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:uu:diva-176793DOI: 10.1016/j.cca.2012.03.011ISI: 000304578200018OAI: oai:DiVA.org:uu-176793DiVA: diva2:537764