The Early Diagnostic Value of Dynamic Changes for High-sensitive Troponin I in Patients With Acute Coronary Syndrome
10.3969/j.issn.1000-3614.2016.01.006
- VernacularTitle:高敏心肌肌钙蛋白I动态变化在急性冠状动脉综合征早期诊断中的应用价值
- Author:
Neng ZHANG
;
Dan ZHANG
;
Yu ZHANG
;
Zhenyu YANG
- Publication Type:Journal Article
- Keywords:
Coronary artery disease;
Myocardium;
Troponin I
- From:
Chinese Circulation Journal
2016;31(1):25-30
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To explore the early diagnostic value of dynamic changes for high-sensitive troponin I (hs-cTnI) in patients with acute coronary syndrome (ACS).
Methods: A total of 186 ACS patients treated in our hospital from 2014-02 to 2015-04 were studied. The patients were divided into 2 groups:AMI group, n=169 and UA group, n=17, in addition, there was a Control group, n=13 healthy subjects. Blood levels of hs-cTnI were measured at admission and 2h, 4h after admission. Dynamic changes of hs-cTnI was calculated by slop coefifcient of hs-cTnI (Δhs-cTnI) at 3 time points and relative changes of hs-cTnI values. ROC curve was made by SPSS 16.0 statistical software and the best diagnostic cutoff point was determined by Youden index.
Results: In clinical practice, hs-cTnI=1 ng/ml was critical condition, hs-cTnI=0.15 ng/ml was recommended for AMI diagnosis. When hs-cTnI<1 ng/ml at admission, the AUC of AMI vs UA and AMI vs Control for 0 h hs-cTnI were 0.6746 and 0.8844;for relative changes of hs-cTnI were 0.9806 and 0.9631;forΔhs-cTnI were 0.9521 and 0.9778 respectively. Thus, the best diagnostic cutoff value of AMI for relative changes of hs-cTnI was 0.6705, sensitivity 70.59%, speciifcity 91.49%;forΔhs-cTnI was 0.0075, sensitivity 68.75%, speciifcity 97.78%. When hs-cTnI<0.15 ng/ml at admission, the AUC of AMI vs UA and AMI vs Control for 0 h hs-cTnI were 0.5677 and 0.7000;for relative changes of hs-cTnI were 0.9228 and 0.9975;forΔhs-cTnI were 0.9044 and 0.8906 respectively. Thus, the best diagnostic cutoff value of AMI for relative changes for hs-cTnI was 2.923, sensitivity 81.25%, speciifcity 94.12%;forΔhs-cTnI was 0.01125, sensitivity 76.47%, speciifcity 93.75%.
Conclusion: AMI could not be effectively diagnosed by hs-cTnI alone at admission, using combined relative changes of hs-cTnI andΔhs-cTnI was superior to 0 h hs-cTnI for AMI diagnosis.
