Acute Coronary Syndrome Clinical Trial
Official title:
Comparison of the New High Sensitive Cardiac Troponin T With the 4th Generation Troponin-T, Myoglobin, Heart-type Fatty Acid Binding Protein for Early Identification of Myocardial Necrosis in Patients With Suspected Acute Coronary Syndrome
OBJECTIVES/BACKGROUND: We sought to determine the early diagnostic value of the new high
sensitive cardiac troponin T assay (TnThs) in suspected acute coronary syndrome (ACS) and to
compare it with the 4th generation cTnT assay from the same manufacturer, myoglobin and
heart-type fatty acid binding protein (h-FABP).
METHODS: The study consisted of 94 patients with chest pain admitted to the chest pain unit
with the diagnosis of suspected ACS without ST-Elevation. Patients were divided according to
time from onset of symptoms to presentation into an early presenter group (<4 hours) and a
late presenter group (≥4 hours).
A median of 6 samples (range 2-8) were available per patient. The diagnostic performance of
TnThs was assessed using ROC analysis and areas under the curve (AUC) of baseline and
follow-up results of TnThs, cTnT, myoglobin, and h-FABP were compared using c-statistics.
RESULTS: The TnThs assay allows an excellent prediction of non-ST-segment-elevation
myocardial infarction (non-STEMI) at presentation.A follow-up sample improves diagnostic
performance in a time dependent manner. The AUC of the TnThs was superior to cTnT at all
time points.
CONCLUSIONS: A baseline sample of TnThs allows an earlier prediction of non-STEMI than the
less sensitive and precise 4th generation cTnT assay. The excellent performance of TnThs at
baseline and follow-up might obviate the need for other early necrosis markers.
n/a
Observational Model: Cohort, Time Perspective: Prospective
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