Diagnostic value of a bedside test for cardiac troponin T in the patient with chest pain presenting to the emergency room.

Abstract

Identification of patients with acute chest pain due to acute coronary syndrome is a common and difficult challenge for emergency physicians. A prospective study was conducted to assess the diagnostic value of a bedside test of cardiac troponin T in the emergency room setting. Forty-nine consecutive patients, who visited the emergency room within 6 hours of the onset of acute chest pain, were enrolled. Of the 26 patients who were ultimately diagnosed as having acute coronary syndrome, seven patients (27%) had positive cardiac troponin T assay results, whereas none of the patients without acute coronary syndrome had positive results (0%). For patients with acute coronary syndrome who presented later than 3 hours after the onset (n = 4), the test was positive in all cases (positive predictive value: 100%, negative predictive value: 100%, p < 0.01). However, the positive rate was only 14% for those who presented earlier than 3 hours after the onset (n = 22) (positive predictive value: 100%, negative predictive value: 47%, p = 0.84). In conclusion, bedside troponin T test results should be evaluated considering the time interval from the onset of chest symptoms.

• Authors: M Suzuki, S Hori, S Fujishima, S Takatsuki, I Nakamura, H Kimura, K Aoki, N Aikawa
• Journal: The Keio journal of medicine (Keio J Med) Vol. 49 Issue 2 Pg. 74-9 (Jun 2000) ISSN: 0022-9717 [Print] Japan
• PMID: 10900832 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Isoenzymes
• Troponin T
• Creatine Kinase

Topics

• Adult
• Aged
• Aged, 80 and over
• Chest Pain (blood)
• Creatine Kinase (blood)
• Electrocardiography
• Emergency Medical Services
• Female
• Humans
• Isoenzymes
• Male
• Middle Aged
• Myocardial Infarction (blood, diagnosis)
• Myocardium (metabolism)
• Prospective Studies
• Troponin T (blood)