Comparison Between Rapid Kit Based Conventional Troponin-T and High Sensitive Troponin-I Chemiluminescence Immunoassay Technique in Patients Presenting With Typical Chest Pain

Abstract

Objectives: Cardiac troponins are keystone in diagnosing and risk stratification of patients with suspected non-ST elevation myocardial infarction (NSTEMI). We aimed to analyze and compare hs-TropI and c-TropT in patients presenting with typical chest pain to emergency department (ER) in our institute. Methodology: Consecutive patients between ages of 20 to 80 years of both genders presenting with typical chest pain for more than 30 minutes were included in the study. Patients with ST elevation on ECG, acute left ventricular failure (LVF), sepsis and chronic kidney disease were excluded from the study. Results: Hundred patients were analyzed presenting with typical chest pain. Mean age of participants was 50+10.75 years. 72 (72%) patients presented with early (<4hrs) chest pain and 28 (28 %) with late ≥4hrs) chest pain. On ECG 57 (57%) patients showed T-wave inversion, 33 (33%) had ST depression and 1 (1%) had left bundle branch block (LBBB). Sensitivity and negative predictive value for hs-TropI was found to be 87% and 94% respectively, while for c-TropT these were 72% and 96%, respectively. Conclusion: This study demonstrated that positive predictive value of c-TropT (conventional troponin T) in diagnosing NSTEMI is low as compared to hs-Trop I (high sensitive troponin I). Thus, it is recommended that lab-based hs-TropI should be preferred over kit-based c-TropT for screening or diagnostic purposes, even though the latter is cost effective and takes less time.