Abstract
Cardiac troponins are the most sensitive and specific biochemical markers of myocardial injury and with the new high-sensitivity troponin methods very minor injuries of the heart muscle can be detected. The introduction of high-sensitivity assays has facilitated reference range adjustments and a revised cut-off point for myocardial infarction (MI) due to an improved performance in the lower concentration range. The objective of this study was to investigate whether implementing a high-sensitivity cardiac troponin T (hs-cTnT) assay with subsequent lowering of the cut-off point changed the hospital evaluation and diagnosis of acute non-ST-segment elevation myocardial infarction (NSTEMI) in a general hospital population. NSTEMI patients admitted to our hospital during two periods each lasting one year were retrospectively compared. During period 1 (August 2007 - July 2008) patients were diagnosed with a conventional troponin T assay, and during period 2 (August 2009 - July 2010) patients were diagnosed using an hs-cTnT assay. A significant increase in the number of NSTEMI admissions was observed using the hs-cTnT assay (225 vs. 341, risk ratio 1.57, 95% confidence interval 1.33 to 1.85). The proportion of patients examined with acute coronary angiography was similar (25.8% vs. 23.8%). Due to the higher number of NSTEMI admissions the total number of angiographies was higher in period 2 (58 vs. 81, p < 0.05), and significantly more patients were examined without signs of coronary artery disease (CAD) (0% vs. 8.6%, p < 0.05). A smaller proportion diagnosed with the high-sensitivity assay had significant dynamic cTnT changes between the highest and lowest cTnT measurement during each admission (96.2% vs. 88.7%, p < 0.01). More patients were diagnosed with NSTEMI and underwent coronary angiography after introducing the hs-cTnT assay. At the same time there was an increase in the frequency of coronary angiograms without signs of CAD, and fewer had significant dynamic cTnT concentration changes.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
