Use of the Centaur TnI-Ultra Assay for Detection of Myocardial Infarction and Adverse Events in Patients Presenting With Symptoms Suggestive of Acute Coronary Syndrome
Open Access
- 1 April 2008
- journal article
- Published by Oxford University Press (OUP) in Clinical Chemistry
- Vol. 54 (4), 723-728
- https://doi.org/10.1373/clinchem.2007.097162
Abstract
Background: We determined the diagnostic accuracy of the Advia Centaur TnI-Ultra assay for detecting myocardial infarction (MI) and assessing risk of adverse events in patients presenting with ischemic symptoms suggestive of acute coronary syndrome. Methods: We measured cardiac troponin I (cTnI) on admission and 6–24 h after admission (follow-up) in plasma specimens from 371 consecutive patients. The end point was the first of cardiac event or death within 60 days. We estimated survival curves using the Kaplan-Meier method and compared groups with the log rank statistic. Results: MI was established in 49 patients (13%). Clinical sensitivities and specificities for MI based on the 99th percentile (0.04 μg/L) were 74% and 84%, respectively, on admission and 94% and 81% at follow-up. ROC curves showed significantly higher accuracy for MI in the follow-up specimen compared with admission (P = 0.001). Overall there were 2 cardiac deaths, 1 noncardiac death, 49 MIs, 7 coronary artery bypass grafts, and 36 percutaneous coronary interventions in 59 patients during follow-up. The event rate in those with cTnI 0.04–0.10 μg/L, or >0.10 μg/L (2.8% vs 11.1%, 24.1%, 55.1%, respectively; P <0.0001). Relative risks for the increasing cTnI cutoff groups were 3.9 (95% CI 1.2–13), 8.9 (2.4–34), and 25 (7.3–82) after adjustment for age, diabetes, history of hypertension, previous MI, and estimated glomerular filtration rate. Conclusions: The TnI-Ultra assay is a sensitive, early diagnostic biomarker for MI and an independent predictor of adverse events at any measurable cTnI in patients with symptoms of acute coronary syndrome.Keywords
This publication has 17 references indexed in Scilit:
- Universal definition of myocardial infarction: Kristian Thygesen, Joseph S. Alpert and Harvey D. White on behalf of the Joint ESC/ACCF/AHA/WHF Task Force for the Redefinition of Myocardial InfarctionEuropean Heart Journal, 2007
- National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines: Clinical Characteristics and Utilization of Biochemical Markers in Acute Coronary SyndromesClinical Chemistry, 2007
- Practical Implementation of the Guidelines for Unstable Angina/Non–ST-Segment Elevation Myocardial Infarction in the Emergency DepartmentAnnals of Emergency Medicine, 2005
- Elevations in Troponin T and I Are Associated With Abnormal Tissue Level PerfusionCirculation, 2002
- Mechanisms behind the prognostic value of troponin T in unstable coronary artery disease: a FRISC II substudyJournal of the American College of Cardiology, 2001
- The prognostic value of troponin in patients with non-ST elevation acute coronary syndromes: a meta-analysisJournal of the American College of Cardiology, 2001
- Bedside Multimarker Testing for Risk Stratification in Chest Pain UnitsCirculation, 2001
- Angiographic findings in patients with refractory unstable angina according to troponin T statusCirculation, 1999
- Elevated cardiac troponin I predicts a high-risk angiographic anatomy of the culprit lesion in unstable anginaAmerican Heart Journal, 1999
- Early Diagnostic Efficiency of Cardiac Troponin I and Troponin T for Acute Myocardial InfarctionAcademic Emergency Medicine, 1997