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Improved early risk stratification and diagnosis of myocardial infarction, using a novel troponin I assay concept.

AbstractBACKGROUND:
We evaluated the clinical performance of a novel cardiac troponin I (cTnI) assay specifically designed to improve the very early risk stratification in acute coronary syndromes.
SUBJECTS AND METHODS:
Serum and plasma samples (taken 0, 6-12 h and 24 h after admission) from 531 patients with suspected acute coronary syndrome were studied using a novel investigational cTnI assay, reference cTnI assay and myoglobin. The lowest cTnI concentration giving a total assay imprecision of 10% was used as the positive myocardial infarction (MI) cut-off value.
RESULTS:
At the time of admission, the investigational assay was positive in 27.9% of the patients, the reference cTnI assay was positive in only 17.5% (P < 0.001) and myoglobin in 24.1% (P = 0.067). Receiver operating characteristic (ROC) curve analysis for the detection of myocardial injury on admission gave area-under-curve (AUC) values of 0.937, 0.775 and 0.762, respectively (P < 0.001). Of those MI patients who presented within 3 h of symptom onset, 50.0% were identified by the investigational assay at the time of presentation, compared with 44.2% by myoglobin (P = 0.791) but only 11.5% by the reference assay (P < 0.001).
CONCLUSIONS:
The novel cTnI assay considerably improves the performance of cTnI as an early rule-in biomarker for MI.
AuthorsT Ilva, S Eriksson, J Lund, P Porela, H Mustonen, K Pettersson, K Pulkki, L-M Voipio-Pulkki
JournalEuropean journal of clinical investigation (Eur J Clin Invest) Vol. 35 Issue 2 Pg. 112-6 (Feb 2005) ISSN: 0014-2972 [Print] England
PMID15667582 (Publication Type: Evaluation Study, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Troponin I
Topics
  • Aged
  • Area Under Curve
  • Early Diagnosis
  • Female
  • Humans
  • Immunoassay (methods, standards)
  • Male
  • Myocardial Infarction (diagnosis)
  • Risk Assessment
  • Sensitivity and Specificity
  • Troponin I (blood)

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