Joint detection of troponin T, high sensitivity C-reactive protein, N-terminal probrain natriuretic peptide applied in the diagnosis of acute coronary syndrome for elderly patients
10.3760/cma.j.issn.0254-9026.2012.09.003
- VernacularTitle:心肌和炎性标志物联合检测在老年急性冠状动脉综合征患者诊断中的应用
- Author:
Yuexia ZHAO
;
Meng WANG
;
Zhiyi TANG
;
Xu CHEN
;
Donghuan WANG
- Publication Type:Journal Article
- Keywords:
Coronary disease;
Troponin T;
Natriuretic peptide,brain;
C-reactive protein;
ROC curve
- From:
Chinese Journal of Geriatrics
2012;31(9):747-752
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the value of the joint detection of Troponin T(TnT),highsensitivity C-reactive protein (hs-CRP) and N-terminal probrain natriuretic peptide (NT-proBNP) for the clinical diagnosis of acute coronary syndrome(ACS) in elderly patients.Methods The adequate serum samples were collected in each group:unstable angina (UA) (49 cases),non-ST segment elevations myocardial infarction(NSTEMI) (48 cases),acute myocardial infarction(AMI) (37 cases)and healthy control (45 cases).The levels of TnT and NT-proBNP were measured by electrochemiluminescent double antibody sandwich method,and hs CRP by immune transmission turbidity.The roles of individual and joint detection of the three indicators were analyzed by ROC curve and Logistic regression model.Results Except for TnT in UA group,the serum TnT,NT-proBNP and hs-CRP levels were significantly higher in three ACS groups than in healthy control group (P＜0.05).The largest areas under the ROC curve (AUC) of individual TnT,NT-proBNP,hs-CRP testing and the joint detection for UA were 0.583±0.059,0.786±0.047,0.620±0.058 and 0.787±0.046,for NSTEMI were 0.967±0.022,0.978±0.015,0.897±0.032 and 0.991 ±0.009,for AMI were 0.971 ± 0.024,0.961 ± 0.021,0.874 ± 0.043 and 0.999 ± 0.002,therefore,the area under the ROC curve of the joint detection was increased to some degree as compared with individual TnT,NT-proBNP,hs-CRP testing.Similarly,the best sensitivity and specificity of individual TnT,NT-proBNP,hs-CRP testing and the joint detection for UA were 16.7％ and 100.0％,54.2％ and 91.1％,54.2％ and 75.6％,50％ and 95.6％; for NSTEMI were 93.5％ and 100.0％,95.7％ and 97.8％,67.4％ and 97.8％,95.7％ and 100.0％; for AMI were 94.1％ and 100.0％,91.2％ and 97.8％,67.8％ and 97.8％,100.0％ and 97.8％,respectively.Conclusions Joint detection of TnT,NT-proBNP,hs-CRP can significantly improve the diagnosis of UA; for NSTEMI and other AMI,it can be achieved the optimism of sensitivity and specificity,but its effect of distinguishing NSTEMI and AMI is little.
