A Comparison of Cardiac Troponin Determinationbetween High-Sensitivity-Cardiac Troponin-I andHigh-Sensitivity-Cardiac Troponin-T assays for Diagnosis of Acute Myocardial Infarction with Non-ST Elevation

Authors

  • ณีรนุช พูลชนะ Faculty of Allied Health Sciences, Thammasat University
  • ถวัลย์ ฤกษ์งาม Faculty of Allied Health Sciences, Thammasat University
  • สมศักดิ์ ฟองสุภา Faculty of Allied Health Sciences, Thammasat University

Keywords:

High sensitive troponin I, High sensitive troponin T, Acute Myocardial Infarction, NSTEMI

Abstract

Non-ST-segment elevation myocardial infarction (NSTEMI) is defined as acute myocardial infarction (AMI)without an increasing value of elevation of electrocardiographic ST-segment.NSTEMI accompany at least one cardiac troponin (cTn) value above cut off value, indicating myocardial necrosis. Mortality rate in NSTEMI patients markedly increased when the treatment is delayed by inaccuracy and late diagnosis. Previousstudies found more sensitive cTn assays including high sensitive troponin I (hs-cTnI) and the high sensitive troponin T (hs-cTnT), used for NSTEMI diagnosis. However, there was limited data about the performance of these assays for NSTEMI diagnosis in Thai people. The aim of this study was to compare the sensitivity and specificity ofhs-cTnI) and hs-cTnT assay for diagnosis of NSTEMI. One hundred thirty with chest pain or angina equivalents in the Emergency Department (ED) of the Chainat hospital were included in the study.After that, electrocardiogram (ECG) was performed and blood samples were collected for determination ofhs-cTnI and hs-cTnT at 0, 1, and 3 hours after admission.

Result: At0 hr, the results showed that 95 patients were diagnosed as NSTEMI. The levelsofhs-cTnI in 124 patients showed higher than cut offpoint (>0.04 ng/mL), whilethe levels of hs-cTnT in 88 patients were higher than cut-off level (>0.10 ng/mL). Sensitivity of hs-cTnI was higher thanhs-cTnT (95.79% and 65.26%, respectively), whereas specificity of hs-cTnT was higher than hs-cTnI (57.10% and 14.29 %, respectively). In addition, the diagnostic performance of cardiac troponin was also determined by receiver-operation-characteristic curve (AUC at95% CI). The results showed that diagnostic performance of hs-cTnI (AUC = 0.73, 95%Cl: 0.66-0.80) was significantly higher than hs-cTnT (AUC=0.73, 95%Cl: 0.63-0.78) (p<0.05) at 0 hr, whereas diagnostic performance of hs-cTnT (AUC=0.71, 95%Cl: 0.64-0.78 and AUC=0.74, 95%Cl: 0.68-0.80, respectively) was significantly higher than hs-cTnI (AUC=0.52, 95%Cl: 0.45-0.60 andAUC=0.59, 95%Cl: 0.51-0.66, respectively) at 1 and 3 h. (p<0.05).

Conclusion: This study revealed that the hs-cTnI showed high-sensitivityfor screening of NSTEMI, whereas the hs-cTnT showed good diagnostic performance for NSTEMI after presentation at 1-3 hr.

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Published

2019-12-29

How to Cite

1.
พูลชนะ ณ, ฤกษ์งาม ถ, ฟองสุภา ส. A Comparison of Cardiac Troponin Determinationbetween High-Sensitivity-Cardiac Troponin-I andHigh-Sensitivity-Cardiac Troponin-T assays for Diagnosis of Acute Myocardial Infarction with Non-ST Elevation. udhhosmj [internet]. 2019 Dec. 29 [cited 2026 Jan. 25];27(3):272-84. available from: https://he02.tci-thaijo.org/index.php/udhhosmj/article/view/232988

Issue

Vol. 27 No. 3 (2019): September - December 2019

Section

Research Article

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