Improved diagnostic and prognostic performance of a new high-sensitive troponin T assay in patients with acute coronary syndrome

Background In the present study, we aimed to analyze the diagnostic and prognostic potential of a newly developed high-sensitive troponin T assay and compared these results with those of a contemporary troponin T assay in 2 distinct patient cohorts, one including patients with evident ACS and the ot...

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Published in:	The American heart journal 2011-07, Vol.162 (1), p.81-88
Main Authors:	Weber, Michael, MD, Bazzino, Oscar, MD, Navarro Estrada, Jose Luis, MD, de Miguel, Raul, Lic, Salzberg, Simon, MD, Fuselli, Juan J., MD, Liebetrau, Christoph, Woelken, Mariella, MD, Moellmann, Helge, MD, Nef, Holger, MD, Hamm, Christian, MD
Format:	Article
Language:	eng
Subjects:	Acute Coronary Syndrome - blood Acute Coronary Syndrome - diagnosis Acute coronary syndromes Aged Biological and medical sciences Biomarkers Biomarkers - blood Cardiology. Vascular system Cardiovascular Cardiovascular disease Consent Coronary heart disease Diabetes Diagnosis, Differential Family medical history Female Follow-Up Studies Heart Heart attacks Humans Hypertension Immunoassay Male Medical imaging Medical sciences Middle Aged Mortality Myocarditis. Cardiomyopathies Pain Prognosis Registries Retrospective Studies ROC Curve Severity of Illness Index Troponin T - blood
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Summary:	Background In the present study, we aimed to analyze the diagnostic and prognostic potential of a newly developed high-sensitive troponin T assay and compared these results with those of a contemporary troponin T assay in 2 distinct patient cohorts, one including patients with evident ACS and the other one including patients with general chest pain. Methods and Results For this study, we analyzed data from 2 independent patient cohorts, the Bad Nauheim ACS registry and the Prognosis in Acute Coronary Syndromes registry, with a total of 2,506 patients. On admission, clinical data have been recorded, and a single measurement of troponin T has been performed with a contemporary assay (TnT) and a new high-sensitive troponin T assay (hsTnT). Clinical follow-up has been obtained after 6 months. The diagnostic value of hsTnT was superior to TnT (area under the receiver operating characteristic curve 0.949 vs 0.929, P = .016). Specifically, in TnT-negative patients, hsTnT provided strong diagnostic information (area under the receiver operating characteristic curve of 0.81, P < .001). Furthermore, hsTnT provided independent prognostic power for mortality within 6 months in both cohorts, which was superior to that of the contemporary TnT assay. Conclusion Troponin T measured with a newly developed hsTnT provides better diagnostic and prognostic information and, therefore, should be implemented as a standard test in clinical routine.
ISSN:	0002-8703 1097-6744