دورية أكاديمية
أعرض في EDS

A novel troponin I rule-out value below the upper reference limit for acute myocardial infarction.

التفاصيل البيبلوغرافية
العنوان: A novel troponin I rule-out value below the upper reference limit for acute myocardial infarction.
المؤلفون: Goorden SM; Atalmedial Diagnostic Centres, Hoofddorp, The Netherlands., van Engelen RA; Department of Cardiology, Spaarne Gasthuis, Haarlem, The Netherlands., Wong LS; Department of Cardiology, Spaarne Gasthuis, Haarlem, The Netherlands., van der Ploeg T; Research Centre Linnaeus Institute Spaarne Gasthuis, Haarlem, The Netherlands., Verdel GJ; Department of Cardiology, Spaarne Gasthuis, Haarlem, The Netherlands., Buijs MM; Atalmedial Diagnostic Centres, Hoofddorp, The Netherlands.
المصدر: Heart (British Cardiac Society) [Heart] 2016 Nov 01; Vol. 102 (21), pp. 1721-1727. Date of Electronic Publication: 2016 Apr 11.
نوع المنشور: Journal Article; Observational Study; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: BMJ Pub. Group Country of Publication: England NLM ID: 9602087 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1468-201X (Electronic) Linking ISSN: 13556037 NLM ISO Abbreviation: Heart Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BMJ Pub. Group, c1996-
مواضيع طبية MeSH: Myocardial Infarction/*blood , Troponin I/*blood, Aged ; Aged, 80 and over ; Angina Pectoris/etiology ; Area Under Curve ; Biomarkers/blood ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction/complications ; Myocardial Infarction/diagnosis ; Predictive Value of Tests ; Prospective Studies ; ROC Curve ; Reference Values ; Reproducibility of Results ; Time Factors ; Up-Regulation
مستخلص: Objective: To determine cut-off values for a recently introduced high sensitive cardiac troponin assay (hs-cTnI) which provide similar sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) for acute myocardial infarction (AMI) as known cut-off values for an hs-cTnT assay.
Methods: A prospective observational study was performed. Hs-cTnT (Roche) and hs-cTnI (Abbott) were measured in consecutive patients with symptoms suggestive of AMI. Representative measurements (obtained at least 3 h after chest pain has started) and serial measurements with a time delay between 2.5 h and 4.5 h were used to determine cut-off levels. Two independent clinicians adjudicated the final diagnosis.
Results: 1490 patients were included in the study of whom 114 (8%) received a final diagnosis of AMI. Receiver operating characteristics analysis showed no statistically significant differences in the areas under the curve between the two assays. Cut-off values for representative hs-TnI were found to be as follows: rule-out: 10 ng/L (sensitivity: 98.2%; 95% CI 95.7% to 100.0% and NPV: 99.8%; 99.5% to 100.0%); rule-in: 70 ng/L (specificity: 90.8%; 89.3% to 92.4% and PPV: 39.7%; 36.1% to 43.3%). For serial measurements we found a Δ rule-out cut-off value of 20 ng/L (sensitivity: 94.9%; 88.0% to 100.0% and NPV: 98.7%; 96.9% to 100.0%) and Δ rule-in cut-off values of 100 ng/L (specificity: 92.7%; 87.9% to 95.8% and PPV: 57.6%; 39.4% to 74.0%) and 300% (specificity: 93.8%; 90.4% to 97.2% and PPV: 61.3%; 51.1% to 71.5%).
Conclusions: Cut-off values for hs-cTnI measurements are determined which allow a similar diagnostic classification as compared with hs-cTnT. Importantly, for a rule-out paradigm this cut-off value is unmistakably lower than the upper reference limit.
(Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.)
التعليقات: Comment in: Heart. 2016 Nov 1;102(21):1772. (PMID: 27733500)
المشرفين على المادة: 0 (Biomarkers)
0 (Troponin I)
تواريخ الأحداث: Date Created: 20160413 Date Completed: 20170717 Latest Revision: 20180124
رمز التحديث: 20221213
DOI: 10.1136/heartjnl-2015-308667
PMID: 27067356
قاعدة البيانات: MEDLINE
الوصف
تدمد:1468-201X
DOI:10.1136/heartjnl-2015-308667