Role of High-sensitivity Cardiac Troponin in Acute Coronary Syndrome

Narayanan, Mahesh Anantha; García, Santiago

doi:10.15420/usc.2018.16.1

Cited by 2 publications

(1 citation statement)

References 68 publications

(72 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The limitations of this study include the NCIC trust’s hs-cTnT assay cutoff of 12 ng/L. The researcher is aware that there are other troponin assays with lower cutoffs (3-5 ng/L) for which a single baseline hs-cTn T measurement improves sensitivity for AMI markedly and can be used as a rule-out test in patients presenting more than three hours after symptom onset [ 20 ]. Also, the observational cohort comprised a medium-risk population attending a secondary care emergency setting.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Sensitivity, Specificity, and Predictive Values of High-Sensitivity Troponin T in a Secondary Care Setting: A Retrospective Cohort Study

Orji

2023

Cureus

View full text Add to dashboard Cite

Background High-sensitivity cardiac troponin (hs-cTn) assays have significantly improved the early detection of myocardial injury and the diagnosis of acute coronary syndrome (ACS). Different diagnostic algorithms exist for the interpretation of hs-cTn in the management of patients with suspected ACS. This study analysed the diagnostic efficacy of hs-cTn using serial and single measurements while also shedding light on the challenges associated with the use of this assay. Methods We reviewed 189 results belonging to 120 unique patient episodes and records for troponin tests performed in a two-week period obtained from the West Cumberland Hospital, North Cumbria Integrated Care (NCIC), Whitehaven, England. These troponin tests were carried out based on the NCIC trust guidelines for the use of troponin assays in the management of acute coronary syndrome (ACS). A positive troponin test is defined using the NCIC trust guidelines and the National Academy of Clinical Biochemistry (NACB) guidelines. The case notes of the unique patients were reviewed to determine the outcome, which is defined as the clinical diagnosis on discharge of the patient following a cardiologist review. These outcomes were then used to calculate the sensitivity, specificity, and predictive values. We also determined the alternate diagnosis for false-positive tests. Results Using both guidelines to assess the clinical effectiveness of the troponin assay yields slightly varying results, with the single positive test of NACB demonstrating a higher sensitivity of 92.8% (>71.4%) and a slightly better negative predictive value of 97.8% (>96%). However, using the serial troponin measurements as per the NCIC trust guideline demonstrates a better specificity of 95.2% (>42.4%) and a positive predictive value of 66% (>17.5%). False positive results are identified, which are due to alternate diagnoses such as stable angina, myocarditis, heart failure, sepsis, and malignancy. Conclusion High-sensitivity troponin (hs-cTn) assays play a crucial role in the early detection and management of patients with suspected ACS. This study supports evidence that serial troponin measurements are more diagnostically accurate than single troponin measurements. Although hs-cTn assays offer significant advantages, there remain challenges and limitations that require careful interpretation and clinical correlation.

show abstract

Section: Discussionmentioning

confidence: 99%

Analysis of Sensitivity, Specificity, and Predictive Values of High-Sensitivity Troponin T in a Secondary Care Setting: A Retrospective Cohort Study

Orji

2023

Cureus

View full text Add to dashboard Cite

show abstract

Association between White Blood Cell to Mean Platelet Volume Ratio (WMR) with Troponin for Refractory Angina Prediction in NSTE-ACS patients

Hermawati

Assegaf

2020

IOP Conf. Ser.: Earth Environ. Sci.

View full text Add to dashboard Cite

Hematological parameters provide independent information as well as troponin in non-ST-Elevation-Acute-Coronary-Syndrome (NSTE-ACS) patient. Refractory angina in NSTE-ACS patients significantly transforms this optimal management due to risk enhancement. This study aims to prove the association of white blood cell (WBC) to mean platelet volume ratio (WMR) with troponin and authenticate the best parameter for refractory angina prediction in NSTE-ACS patients. This observational study was conducted in ICCU Dr. Soetomo General Hospital, Surabaya. There were 49 NSTE-ACS patients recruited as the study subject. Complete Blood Count (CBC), High Sensitivity Cardiac Troponin I (hs-cTnI) and CKMB examinations were conducted at the time of admission. We observed angina symptom for three months. The mean age of the patients was 60.8±8.67 years, and 75.5% of them were male. Elevated hs-cTnI level was found in 83.7% of study subjects. WMR significantly correlated with hs-cTnI (r=0.434 p=0.002). Refractory angina was found in 14.3% of study subjects. There was a positive moderate correlation of WMR and refractory angina (r=0.534 p=0.000), a positive moderate significant correlation of hs-cTnI and refractory angina (r=0.470 p=0.001). No significant correlation of other parameters. This study proved that WMR was an independent hematological predictor for refractory angina event in NSTE-ACS patients with higher significance level than hs-cTnI.

show abstract

Role of High-sensitivity Cardiac Troponin in Acute Coronary Syndrome

Cited by 2 publications

References 68 publications

Analysis of Sensitivity, Specificity, and Predictive Values of High-Sensitivity Troponin T in a Secondary Care Setting: A Retrospective Cohort Study

Analysis of Sensitivity, Specificity, and Predictive Values of High-Sensitivity Troponin T in a Secondary Care Setting: A Retrospective Cohort Study

Association between White Blood Cell to Mean Platelet Volume Ratio (WMR) with Troponin for Refractory Angina Prediction in NSTE-ACS patients

Contact Info

Product

Resources

About