High sensitivity cardiac troponin T in patients not having an acute coronary syndrome: results from the TRAPID-AMI study.
Nowak R, Muller C, Giannitsis E, Christ M, Ordonez-Llanos J, DeFilippi C, McCord J, Body R, Panteghini M, Jernberg T, Plebani M, Verschuren F, French JK, Christenson R, Jacobsen G, Dinkel C, and Lindahl B. High sensitivity cardiac troponin t in patients not having an acute coronary syndrome: Results from the trapid-ami study. Biomarkers 2017:1-26.
Biomarkers : biochemical indicators of exposure, response, and susceptibility to chemicals
PURPOSE: To describe the baseline, 1 hr and delta high sensitivity cardiac troponin (hs-cTnT) values in patients with suspected acute myocardial infarction (AMI) but without a final acute coronary syndrome (ACS) diagnosis.
MATERIALS AND METHODS: hs-cTnT assay for RAPID rule out of acute myocardial infarction (TRAPID-AMI) was a prospective diagnostic trial that enrolled emergency department (ED) patients with suspected AMI. Final patient diagnoses were adjudicated by a clinical events committee and subjects placed in different clinical groups: AMI, unstable angina, non-ACS cardiac, non-cardiac and unknown origin. The baseline, 1 hr and delta hs-cTnT values were analysed in the 902 non-ACS patients.
RESULTS: Amongst the 1282 studied the patient groups were 213 (17%) AMI, 167 (13%) unstable angina, 113 (9%) non-ACS cardiac, 288 (22%) non-cardiac and 501 (39%) unknown origin. The hs-cTnT values in the non-cardiac and unknown origin groups were combined. The median hs-cTnT values (ng/L) were higher (p < 0.001) in the non-ACS cardiac compared to the non-cardiac/unknown origin group at baseline (11.8, <5) and 1 hr (12.3, <5). Their negative predictive values were 0.955 (baseline) and 0.954 (1 hr) for predicting non-ACS cardiac versus non-cardiac/unknown origin diagnoses.
CONCLUSIONS: Hs-cTnT may help predict whether non-ACS ED patients have a final non-ACS cardiac or non-cardiac/unknown origin diagnoses.
Medical Subject Headings
Acute Coronary Syndrome; Adult; Aged; Aged, 80 and over; Biomarkers; Emergency Service, Hospital; Female; Humans; Male; Middle Aged; Myocardial Infarction; Myocardium; Prospective Studies; Sensitivity and Specificity; Troponin T