Diagnostic potential of phosphorylated cardiac troponin I as a sensitive, cardiac-specific marker for early acute coronary syndrome: Preliminary report

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• 作者：David Bar-Or ; Gregory W. Thomas ; Raphael Bar-Or ; Leonard Rael and James V. Winkler
• 刊名：Clinica Chimica Acta
• 出版年：2005
• 期刊代码：54_00098981
• 类别：med
• 出版时间：2005
• 卷：362
• 期：1-2
• 页码：65-70
• 文件大小：98 K

摘要

Background

Cardiac troponin I (cTnI) has low sensitivity in the early hours of acute coronary syndrome (ACS). For patients with early ACS symptoms, we determined the diagnostic potential of an immunoassay for phosphorylated cTnI (PO₄-cTnI).

Methods

In a prospective study of 61 emergency department patients with suspected ACS, we compared a novel plasma immunoassay for PO₄-cTnI to cTnI overall and in a subgroup with symptoms ≤ 4 h duration (n = 31). Admission PO₄-cTnI and cTnI assays (thresholds determined by ROC curve) were analyzed in a blinded fashion against the clinical, ECG and coronary angiographic diagnosis of ACS.

Results

Overall, PO₄-cTnI sensitivity was significantly higher than cTnI (82%vs. 50%, respectively, P < 0.05) and PO₄-cTnI specificity was 81%(n = 61). Addition of PO₄-cTnI to cTnI improved sensitivity to 91%vs. 50%for cTnI alone (P < 0.001). In the ≤ 4 h subgroup (n = 31), PO₄-cTnI sensitivity was significantly higher than cTnI (79%vs. 26%, respectively, P < 0.01) and PO₄-cTnI specificity was 75%. In the same ≤ 4 h subgroup, addition of PO₄-cTnI to cTnI improved sensitivity to 84%vs. 26%for cTnI alone (P = 0.001).

Conclusions

The results suggest that PO₄-cTnI, alone or in combination with cTnI, warrants further investigation as a sensitive, cardiac-specific diagnostic tool for early ACS.