Direct comparison of high-sensitivity-cardiac troponin I vs. T for the early diagnosis of acute myocardial infarction
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Direct comparison of high-sensitivity-cardiac troponin I vs. T for the early diagnosis of acute myocardial infarction. / Rubini Gimenez, Maria; Twerenbold, Raphael; Reichlin, Tobias; Wildi, Karin; Haaf, Philip; Schaefer, Miriam; Zellweger, Christa; Moehring, Berit; Stallone, Fabio; Sou, Seoung Mann; Mueller, Mira; Denhaerynck, Kris; Mosimann, Tamina; Reiter, Miriam; Meller, Bernadette; Freese, Michael; Stelzig, Claudia; Klimmeck, Irina; Voegele, Janine; Hartmann, Beate; Rentsch, Katharina; Osswald, Stefan; Mueller, Christian.
In: EUR HEART J, Vol. 35, No. 34, 07.09.2014, p. 2303-11.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Direct comparison of high-sensitivity-cardiac troponin I vs. T for the early diagnosis of acute myocardial infarction
AU - Rubini Gimenez, Maria
AU - Twerenbold, Raphael
AU - Reichlin, Tobias
AU - Wildi, Karin
AU - Haaf, Philip
AU - Schaefer, Miriam
AU - Zellweger, Christa
AU - Moehring, Berit
AU - Stallone, Fabio
AU - Sou, Seoung Mann
AU - Mueller, Mira
AU - Denhaerynck, Kris
AU - Mosimann, Tamina
AU - Reiter, Miriam
AU - Meller, Bernadette
AU - Freese, Michael
AU - Stelzig, Claudia
AU - Klimmeck, Irina
AU - Voegele, Janine
AU - Hartmann, Beate
AU - Rentsch, Katharina
AU - Osswald, Stefan
AU - Mueller, Christian
N1 - Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.
PY - 2014/9/7
Y1 - 2014/9/7
N2 - AIM: It is unknown whether cardiac troponin (cTn) I or cTnT is the preferred biomarker in the early diagnosis of acute myocardial infarction without ST segment elevation (NSTEMI).METHODS AND RESULTS: In a prospective multicentre study, we measured cTnI and cTnT using clinically available high-sensitivity assays (hs-cTnI Abbott and hs-cTnT Roche) and compared their diagnostic and prognostic accuracies in consecutive patients presenting to the emergency department with acute chest pain. The final diagnosis was adjudicated by two independent cardiologists using all information pertaining to the individual patient. The mean follow-up was 24 months. Among 2226 consecutive patients, 18% had an adjudicated final diagnosis of NSTEMI. Diagnostic accuracy at presentation as quantified by the area under the receiver-operating-characteristics curve (AUC) for NSTEMI was very high and similar for hs-cTnI [AUC: 0.93, 95% confidence interval (CI) 0.92-0.94] and hs-cTnT (0.94, 95% CI: 0.92-0.94) P = 0.62. In early presenters (<3 h since chest pain onset) hs-cTnI showed a higher diagnostic accuracy (AUC: 0.92, 95% CI: 0.89-0.94) when compared with hs-cTnT AUC (0.89, 95% CI: 0.86-0.91) (P = 0.019), while hs-cTnT was superior in late presenters [AUC hs-cTnT 0.96 (95% CI: 0.94-0.96) vs. hs-cTnI 0.94 (95% CI: 0.93-0.95); P = 0.007]. The prognostic accuracy for all-cause mortality, quantified by AUC, was significantly higher for hs-cTnT (AUC: 0.80; 95% CI: 0.78-0.82) when compared with hs-cTnI (AUC: 0.75; 95% CI: 0.73-0.77; P < 0.001).CONCLUSION: Both hs-cTnI and hs-cTnT provided high diagnostic and prognostic accuracy. The direct comparison revealed small but potentially important differences that might help to further improve the clinical use of hs-cTn.
AB - AIM: It is unknown whether cardiac troponin (cTn) I or cTnT is the preferred biomarker in the early diagnosis of acute myocardial infarction without ST segment elevation (NSTEMI).METHODS AND RESULTS: In a prospective multicentre study, we measured cTnI and cTnT using clinically available high-sensitivity assays (hs-cTnI Abbott and hs-cTnT Roche) and compared their diagnostic and prognostic accuracies in consecutive patients presenting to the emergency department with acute chest pain. The final diagnosis was adjudicated by two independent cardiologists using all information pertaining to the individual patient. The mean follow-up was 24 months. Among 2226 consecutive patients, 18% had an adjudicated final diagnosis of NSTEMI. Diagnostic accuracy at presentation as quantified by the area under the receiver-operating-characteristics curve (AUC) for NSTEMI was very high and similar for hs-cTnI [AUC: 0.93, 95% confidence interval (CI) 0.92-0.94] and hs-cTnT (0.94, 95% CI: 0.92-0.94) P = 0.62. In early presenters (<3 h since chest pain onset) hs-cTnI showed a higher diagnostic accuracy (AUC: 0.92, 95% CI: 0.89-0.94) when compared with hs-cTnT AUC (0.89, 95% CI: 0.86-0.91) (P = 0.019), while hs-cTnT was superior in late presenters [AUC hs-cTnT 0.96 (95% CI: 0.94-0.96) vs. hs-cTnI 0.94 (95% CI: 0.93-0.95); P = 0.007]. The prognostic accuracy for all-cause mortality, quantified by AUC, was significantly higher for hs-cTnT (AUC: 0.80; 95% CI: 0.78-0.82) when compared with hs-cTnI (AUC: 0.75; 95% CI: 0.73-0.77; P < 0.001).CONCLUSION: Both hs-cTnI and hs-cTnT provided high diagnostic and prognostic accuracy. The direct comparison revealed small but potentially important differences that might help to further improve the clinical use of hs-cTn.
KW - Aged
KW - Area Under Curve
KW - Biomarkers/metabolism
KW - Early Diagnosis
KW - Humans
KW - Middle Aged
KW - Myocardial Infarction/diagnosis
KW - Prognosis
KW - Prospective Studies
KW - Sensitivity and Specificity
KW - Troponin I/metabolism
KW - Troponin T/metabolism
U2 - 10.1093/eurheartj/ehu188
DO - 10.1093/eurheartj/ehu188
M3 - SCORING: Journal article
C2 - 24842285
VL - 35
SP - 2303
EP - 2311
JO - EUR HEART J
JF - EUR HEART J
SN - 0195-668X
IS - 34
ER -
