Diagnostic and prognostic performance of a novel high-sensitivity cardiac troponin T assay compared to a contemporary sensitive cardiac troponin I assay in patients with acute coronary syndrome

• Verfasst von: Müller-Hennessen, Matthias [VerfasserIn]
• Verfasst von: Celik, Sultan [VerfasserIn]
• Verfasst von: Biener, Moritz [VerfasserIn]
• Verfasst von: Vafaie, Mehrshad [VerfasserIn]
• Verfasst von: Schwöbel, Katrin Rosemarie [VerfasserIn]
• Verfasst von: Katus, Hugo [VerfasserIn]
• Verfasst von: Giannitsis, Evangelos [VerfasserIn]
• Titel: Diagnostic and prognostic performance of a novel high-sensitivity cardiac troponin T assay compared to a contemporary sensitive cardiac troponin I assay in patients with acute coronary syndrome
• Verf.angabe: M. Mueller, S. Celik, M. Biener, M. Vafaie, K. Schwoebel, K. C. Wollert, J. L. Januzzi, H. A. Katus, E. Giannitsis
• E-Jahr: 2012
• Jahr: 25 May 2012
• Umfang: 9 S.
• Fussnoten: Gesehen am 07.08.2018
• Titel Quelle: Enthalten in: Clinical research in cardiology
• Ort Quelle: Berlin : Springer, 2006
• Jahr Quelle: 2012
• Band/Heft Quelle: 101(2012), 10, Seite 837-845
• ISSN Quelle: 1861-0692
• DOI: doi:10.1007/s00392-012-0469-6
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1578328918

Abstract

ObjectiveThe study sought to compare the clinical performance of two more sensitive cardiac troponin (cTn) assays, a novel high-sensitivity (hs) troponin T assay and a contemporary cTnI assay.MethodsWe measured hs-cTnT (Roche TnThs) and cTnI (Siemens Centaur Ultra) on presentation in 1,384 patients with suspected acute coronary syndrome (ACS) who underwent early invasive strategy within 24 h after presentation. Kaplan-Meier, Cox proportional hazards, and receiver-operating characteristic (ROC) analysis was used to compare their prognostic performance for the prediction of all-cause death and death/MI (myocardial infarction) after a median of 271 days. We also compared the diagnostic performance of these assays on presentation for early diagnosis of non-STEMI.ResultsBoth hs-cTnT and cTnI were independently predictive of long-term death (OR 3.51 vs. 2.19) and the composite of death/MI (OR 9.24 vs. 3.61), across the spectrum of ACS and in patients without ACS. When used as a continuous variable, ROC analysis demonstrated significantly higher areas under the curve (AUC) for hs-cTnT as compared to cTnI for the prediction of death/MI (0.721 vs. 0.672, P = 0.024), a trend to better prediction of all-cause death (0.721 vs. 0.672, P = 0.093) and significantly higher AUC for early diagnosis of non-STEMI (0.965 vs. 0.901, P < 0.001).ConclusionUsing the 99th percentile cutoff for hs-cTnT and cTnI, both assays enable prediction of adverse long-term outcomes and earlier diagnosis of non-STEMI. Used as a continuous variable, the hs-cTnT assay showed superior performance compared to the cTnI assay, especially in regard to prognosis.