Document Detail


Discordant Diagnoses of Acute Myocardial Infarction due to the Different Use of Assays and Cut-Off Points of Cardiac Troponins.
MedLine Citation:
PMID:  22890469     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objectives: Several assays for the measurement of cardiac troponin (cTn) are available, but differences in their analytical performances may affect the diagnosis of acute myocardial infarction (MI). Methods: A survey was conducted at all Danish departments of clinical biochemistry at hospitals receiving patients with suspected acute MI to gather information about the assay and cut-off value used. cTn was measured in blood samples from 574 patients enrolled into the Odense Chest Pain Biobank with 3 different assays: the 4th generation cTnT (cTnT(4th)), high-sensitivity cTnT (cTnT(hs); Roche Diagnostics) and cTnI (Abbott Diagnostics). To evaluate concordance, patients were dichotomised according to the 99th percentile value for each assay. Additionally, a cut-off at 50 ng/l for cTnT(hs) was used, as this is the currently employed cut-off point in Denmark. Results: Using a cTnT(4th) cut-off value of >0.03 µg/l, 130 patients (23%) had potential MI. With the cTnT(hs) assay and cut-off values at 50 versus 14 ng/l, respectively, 136 (24%) versus 301 (52%) patients had potential MI. With the cTnI cut-off point, 205 patients (36%) should be considered as having had an acute MI. Conclusions: The use of different cTn assays and cut-off values may result in a discordant frequency of MI diagnoses. This makes efforts to harmonize cTn assays and cut-off levels mandatory.
Authors:
Maria Lyck Hansen; Lotte Saaby; Mads Nybo; Lars Melholt Rasmussen; Kristian Thygesen; Hans Mickley; Tina Svenstrup Poulsen
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-10
Journal Detail:
Title:  Cardiology     Volume:  122     ISSN:  1421-9751     ISO Abbreviation:  Cardiology     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1266406     Medline TA:  Cardiology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  225-229     Citation Subset:  -    
Copyright Information:
Copyright © 2012 S. Karger AG, Basel.
Affiliation:
Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark.
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