Clinical application of high-sensitivity cardiac troponin T assay in the diagnosis of acute myocardial infarction
10.3760/cma.j.issn.1009-9158.2010.09.005
- VernacularTitle:高敏感心肌肌钙蛋白T检测方法在诊断急性心肌梗死中的价值
- Author:
Jiong WU
;
Lingyan SONG
;
Chunyan ZHANG
;
Wei GUO
;
Binbin SONG
;
Beili WANG
;
Bin TANG
;
Yan XI
;
Baishen PAN
- Publication Type:Journal Article
- Keywords:
Troponin T;
Myocardial infarction;
Diagnostic techniques and procedures;
Evaluation studies
- From:
Chinese Journal of Laboratory Medicine
2010;33(9):825-830
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the clinical application of hs-cTnT in diagnosis of AMI. Methods The detectable rates of hs-cTnT and con-cTnT from 147 AMI ( including 122 NSTEMI )patients on immediate admission were compared. The related biological markers including hs-cTnT, con-cTnT, CKMB mass and MYO were determined for all samples from 481 patients with chest pain on immediate admission and 4 h, 12 h ,20 h and 28 h after admission. The receiver operating characteristic curve was used to evaluate the sensitivity and specificity of all markers. The change rates of hs-cTnT within 4 hours from AMI group, non-AMI heart disease group, AMI related high risk disease group and control group were compared with serial detection. Results The detection rates of hs-cTnT for AMI and NSTEMI patients were 90. 3% and 91.0%, and both were significantly higher than the rates of con-cTnT, which were 61.9% and 60. 6% (x2 =23.08,18. 64,all P＜0. 01 ). Among different makers obtained from different collecting times,hs-cTnT had the highest detection rate. For admission cases, the area under curve of hs-cTnT, con-cTnT,CKMB mass and MYO were 0.935, 0.851, 0.827 and 0.769 respectively, and the differences have statistical significance(Z1 = 3. 13, Z2 = 4. 46, Z3 = 5.62, all P ＜ 0. 05 ). Besides, there was a significant difference between the change rate of hs-cTnT of AMI and other groups (x2=166.09,P＜0. 01).Conclusions In comparison with con-cTnT, hs-cTnT could provide reliable results for earlier diagnosis of AMI, and could also reduce misdiagnosis and missed diagnosis of NSTEMI. Combining single test of hs-cTnT with serial tests was superior to using cut-off value alone in diagnosis. Moreover, it could be helpful to distinguish non-AMI patients from true AMI patients due to the improved detection sensitivity. Because of its good diagnostic performance, hs-cTnT test may limit the application value of some other "early markers".
