Details

Autor(en) / Beteiligte

• SCHARNHORST, Volkher
• KRASZNAI, Krisztina
• VAN'T VEER, Marcel
• MICHELS, Rolf

Titel

Rapid Detection of Myocardial Infarction With a Sensitive Troponin Test

Ist Teil von

• American journal of clinical pathology, 2011-03, Vol.135 (3), p.424-428

Ort / Verlag

Chicago, IL: American Society of Clinical Pathologists

Erscheinungsjahr

2011

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Rapid identification and treatment of patients with a myocardial infarction (MI) is mandatory. We studied the diagnostic capacities of a sensitive troponin assay for detection of MI in emergency department patients within 2 hours after arrival. The study included 157 patients suspected of having non-ST-elevation acute coronary syndrome. Blood was drawn on arrival (T0) and 2 (T2), 6, and 12 hours later. At T2, a troponin concentration above the MI cutoff is 87% sensitive and 100% specific for MI detection (positive predictive value [PPV], 100%; negative predictive value [NPV], 96%). If a difference of more than 30% between the troponin measurements at T0 and T2 in the absence of an absolute troponin increase above the 99th percentile of a reference population is also considered indicative of MI, the sensitivity increases to 100% and specificity decreases to 87% (PPV, 70%; NPV, 100%). Sensitivity and specificity of creatine kinase-MB and myoglobin are lower than those of troponin. By using a sensitive troponin assay and simple algorithms, the diagnosis of MI can be determined within 2 hours after arrival at the emergency department. Measurement of myoglobin and creatine kinase-MB has no added value.