Improved diagnostic and prognostic performance of a new high-sensitive troponin T assay in patients with acute coronary syndrome

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• 作者：Michael Weber MD^a ; ^e ; ^{M.Weber@Kreiskliniken-dadi.de"" rel=""nofollow} ; Oscar Bazzino MD^b ; ^e ; Jose Luis Navarro Estrada MD^b ; Raul de Miguel Lic^b ; Simon Salzberg MD^c ; Juan J. Fuselli MD^d ; Christoph Liebetrau^a ; Mariella Woelken MD^a ; Helge Moellmann MD^a ; Holger Nef MD^a ; Christian Hamm MD^a
• 刊名：American Heart Journal
• 出版年：2011
• 出版时间：July 2011
• 年：2011
• 卷：162
• 期：1
• 页码：81-88
• 全文大小：178 K

文摘

Background

In the present study, we aimed to analyze the diagnostic and prognostic potential of a newly developed high-sensitive troponin T assay and compared these results with those of a contemporary troponin T assay in 2 distinct patient cohorts, one including patients with evident ACS and the other one including patients with general chest pain.

Methods and Results

For this study, we analyzed data from 2 independent patient cohorts, the Bad Nauheim ACS registry and the Prognosis in Acute Coronary Syndromes registry, with a total of 2,506 patients. On admission, clinical data have been recorded, and a single measurement of troponin T has been performed with a contemporary assay (TnT) and a new high-sensitive troponin T assay (hsTnT). Clinical follow-up has been obtained after 6 months. The diagnostic value of hsTnT was superior to TnT (area under the receiver operating characteristic curve 0.949 vs 0.929, P = .016). Specifically, in TnT-negative patients, hsTnT provided strong diagnostic information (area under the receiver operating characteristic curve of 0.81, P < .001). Furthermore, hsTnT provided independent prognostic power for mortality within 6 months in both cohorts, which was superior to that of the contemporary TnT assay.

Conclusion

Troponin T measured with a newly developed hsTnT provides better diagnostic and prognostic information and, therefore, should be implemented as a standard test in clinical routine.