Document Detail


The diagnostic value of troponin T testing in the community setting.
MedLine Citation:
PMID:  15964644     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Many patients presenting with chest pain to their family physician are referred to the emergency room, in part, due to lack of accurate objective diagnostic tools. This study aimed to assess the diagnostic value of bedside troponin T kit testing in patients presenting with chest pain to their family physician. DESIGN: Prospective, multi-center study. METHODS: Consecutive subjects with chest pain were recruited from 44 community clinics in Jerusalem. Following clinical assessment by the family physician, qualitative troponin kit testing was performed. Patients with a negative clinical assessment and negative troponin kit were sent home and all others were referred to the emergency room. The final diagnosis at the time of hospital discharge was recorded and telephone follow up was performed after 60 days. Positive predictive value, negative predictive value, sensitivity and specificity of troponin kit for myocardial infarction diagnosis and of family physician for hospitalization, were assessed. RESULTS: Of 392 patients enrolled, 349 (89%) were included in the final analysis. The prevalence of myocardial infarction was 1.7%. The positive and negative predictive values of the troponin kit for myocardial infarction diagnosis were 100% and 99.7%, respectively. The positive and negative predictive values of the family physician's assessment to predict hospitalization were 41.4% and 94.1%, respectively. CONCLUSIONS: Troponin kit testing is an important tool to assist the family physician in the assessment of patients with chest pain in the community setting. Troponin kit testing may identify otherwise undiagnosed cases of myocardial infarctions, and reduce unnecessary referrals to the emergency room.
Authors:
David Planer; David Leibowitz; Ora Paltiel; Rina Boukhobza; Chaim Lotan; Teddy A Weiss
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study     Date:  2005-06-17
Journal Detail:
Title:  International journal of cardiology     Volume:  107     ISSN:  0167-5273     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-02-28     Completed Date:  2006-07-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  369-75     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Hadassah-Hebrew University Medical Center, Mount Scopus Campus, POB 24035, Jerusalem, Israel. dplaner@md.huji.ac.il
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MeSH Terms
Descriptor/Qualifier:
Ambulatory Care*
Biological Markers / blood
Chest Pain / diagnosis*
Family Practice
Female
Humans
Israel
Male
Middle Aged
Myocardial Infarction / diagnosis*
Prospective Studies
Reagent Kits, Diagnostic*
Referral and Consultation
Sensitivity and Specificity
Troponin T / blood*
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Reagent Kits, Diagnostic; 0/Troponin T

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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