BACKGROUND: We sought to determine the diagnostic accuracy of the cardiac troponin I (cTnI) VITROS(R) Troponin I-ES assay for early detection of acute myocardial infarction (AMI) and for risk prediction of adverse events in patients with symptoms of acute coronary syndrome (ACS). METHODS: cTnI was measured on admission and approximately 6 h postadmission in 381 patients. The 99th percentile cTnI concentration (0.034 microg/L) and change [delta (delta)] between admission and follow-up concentrations were evaluated in diagnostic sensitivity and specificity calculations. Risk of cardiac event or death within 60 days was evaluated by Cox proportional hazards regression. RESULTS: AMI occurred in 52 patients. Diagnostic sensitivities (95% CI) of admission and follow-up cTnIs for AMI were 69% (55%-81%) and 94% (84%-99%), respectively. The corresponding specificities (95% CI) were 78% (73%-82%) and 81% (77%-85%), and ROC curve areas were 0.82 vs 0.96 (P < 0.001). Deltas between admission and follow-up cTnI >30% had a sensitivity of 75% (95% CI 61%-86%) and a specificity of 91% (95% CI 87%-94%). During follow-up, 1 cardiac death, 2 noncardiac deaths, 52 AMIs, 6 coronary artery bypass grafts, and 43 percutanous coronary interventions occurred in 62 patients. A delta cTnI >30%, when added to either initial cTnI >0.034 microg/L or follow-up cTnI >0.034 microg/L, improved risk stratification for cardiac event or death (P < 0.001). CONCLUSIONS: Admission cTnI measured by the VITROS ES assay is a sensitive biomarker for detection of AMI. Utilizing >30% cTnI delta in addition to either the baseline or follow-up concentration improved both specificity and risk assessment in patients presenting with symptoms of ACS.
BACKGROUND: We sought to determine the diagnostic accuracy of the cardiac troponin I (cTnI) VITROS(R) Troponin I-ES assay for early detection of acute myocardial infarction (AMI) and for risk prediction of adverse events in patients with symptoms of acute coronary syndrome (ACS). METHODS:cTnI was measured on admission and approximately 6 h postadmission in 381 patients. The 99th percentile cTnI concentration (0.034 microg/L) and change [delta (delta)] between admission and follow-up concentrations were evaluated in diagnostic sensitivity and specificity calculations. Risk of cardiac event or death within 60 days was evaluated by Cox proportional hazards regression. RESULTS: AMI occurred in 52 patients. Diagnostic sensitivities (95% CI) of admission and follow-up cTnIs for AMI were 69% (55%-81%) and 94% (84%-99%), respectively. The corresponding specificities (95% CI) were 78% (73%-82%) and 81% (77%-85%), and ROC curve areas were 0.82 vs 0.96 (P < 0.001). Deltas between admission and follow-up cTnI >30% had a sensitivity of 75% (95% CI 61%-86%) and a specificity of 91% (95% CI 87%-94%). During follow-up, 1 cardiac death, 2 noncardiac deaths, 52 AMIs, 6 coronary artery bypass grafts, and 43 percutanous coronary interventions occurred in 62 patients. A delta cTnI >30%, when added to either initial cTnI >0.034 microg/L or follow-up cTnI >0.034 microg/L, improved risk stratification for cardiac event or death (P < 0.001). CONCLUSIONS: Admission cTnI measured by the VITROS ES assay is a sensitive biomarker for detection of AMI. Utilizing >30% cTnI delta in addition to either the baseline or follow-up concentration improved both specificity and risk assessment in patients presenting with symptoms of ACS.
Authors: Moritz Biener; Matthias Mueller; Mehrshad Vafaie; Allan S Jaffe; Christian Widera; Hugo A Katus; Evangelos Giannitsis Journal: Eur Heart J Acute Cardiovasc Care Date: 2013-07-15
Authors: Lutz Frankenstein; Andrew Remppis; Evangelos Giannitis; Joerdis Frankenstein; Georg Hess; Dietmar Zdunek; Andreas Doesch; Christian Zugck; Hugo A Katus Journal: Clin Res Cardiol Date: 2011-02-17 Impact factor: 5.460
Authors: Peter A Kavsak; Andrew Worster; John J You; Mark Oremus; Adell Elsharif; Stephen A Hill; P J Devereaux; Andrew R MacRae; Allan S Jaffe Journal: Clin Biochem Date: 2009-12-21 Impact factor: 3.281
Authors: Solmaz Assa; Ron T Gansevoort; Ralf Westerhuis; Anneke C Muller Kobold; Adriaan A Voors; Paul E de Jong; Stephan J L Bakker; Casper F M Franssen Journal: Clin Res Cardiol Date: 2013-02-09 Impact factor: 5.460