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The early diagnostic and prognostic utility of high-sensitive troponin assays in acute myocardial infarction: a meta-analysis.
MedLine Citation:
PMID:  25403852     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To determine the diagnostic and prognostic utility of high-sensitive troponin assays in very early phase of AMI (less than 3 hours since symptoms onset) by performing a meta-analysis of prospective studies.
DATA AND SOURCES: Relevant studies were identified by searches of MEDLINE and Elsevier Sciencedirect until January 31st, 2014 and by reviewing the reference lists from retrieved articles.
STUDY SELECTION: Prospective studies that reported diagnostic utility in AMI using both high-sensitive troponin assays and conventional cardiac troponin, and reported the estimates of hazard ratio (HR) with 95% confidence intervals (CIs) for prognostic utility were included.
DATA EXTRACTION AND SYNTHESIS: Data were extracted independently by two authors and summary estimates of association were obtained using a random-effects model.
RESULTS: Of the 7 studies included, 4 studies reported the diagnostic utility of high-sensitive troponin assays (2863 Patients) and 3 reported the prognostic utility in AMI (2329 Patients). Within 12 hours since the symptoms onset, the pooled sensitivity and specificity of high-sensitive troponin assays were 0.89 (95%CI 0.85-0.91) and 0.89 (95%CI 0.85-0.92), respectively, and within 3 hours the pooled sensitivity and specificity of high-sensitive troponin assays were 0.79 (95%CI 0.71-0.85) and 0.92 (95%CI 0.88-0.96), respectively. Compared with conventional cardiac troponin assays, the high-sensitive troponin assays had higher sensitivity (0.89 vs 0.72) but lower specificity (0.89 vs 0.95) in diagnosing AMI within 12 hours since the symptoms onset. Within 3 hours, the sensitivity of high-sensitive troponin assays was still higher (0.79 vs 0.59), but the specificity was almost the same (0.92 vs 0.95) as which of conventional troponin assays. The elevated high-sensitive troponin assays had an overall pooled HRs of 2.66 (95%CI 1.31-5.44) and 2.14 (95%CI 1.15-3.98) for the endpoints of death and non-fatal AMI, respectively.
CONCLUSIONS: These findings provide quantitative data supporting that the high-sensitive troponin assays have early diagnostic and prognostic utility in AMI.
Authors:
Wei-Jie Li; Xu-Miao Chen; Xiao-Ying Nie; Xiao-Xiong Lin; Yun-Jiu Cheng; Cheng-Heng Hu; Zhi-Ming Du; Yu-Gang Dong; Hong Ma; Su-Hua Wu
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-11-18
Journal Detail:
Title:  Internal medicine journal     Volume:  -     ISSN:  1445-5994     ISO Abbreviation:  Intern Med J     Publication Date:  2014 Nov 
Date Detail:
Created Date:  2014-11-18     Completed Date:  -     Revised Date:  2014-11-19    
Medline Journal Info:
Nlm Unique ID:  101092952     Medline TA:  Intern Med J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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This article is protected by copyright. All rights reserved.
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