Abstract

OBJECTIVE

Troponin I (TnI) is an important componentin the diagnosis of acute coronary syndromes (ACS) patients and their management. The use of high sensitive TnI test enables the detection at low levels of TnI in the patients with early ACS. While the high analytical sensitivity increases clinical sensitivity for the diagnosis of myocardial infarction (MI), it accompanies by decreased specificity and increased false positive.The aimof this study wasto evaluate the diagnostic valueof Ultra-TnIin patients admitted to emergency departmentwithchest painand performed coronary angiography.

METHODS

The TnI levels of 200 patients, who are admitted to the emergency department with chest pain and performed the coronary angiography, were investigated retrospectively through the hospital information system. Serum TnI levels were determined with Ultra-TnI reagent (Siemens Healthcare Diagnostic). The diagnostic performance of TnI were estimated in first admission and within 12 hours.

RESULTS

False positive ratio and false negative ratio were determined as 26% and 32% at the first 3 hours. The sensitivity and specificity of TnI were 74% and 68% for the first 3 hours. With the series measurements, while false negative ratio dropped to 9.6%, the sensitivity, the negative predictive value and the positive predictive value increased to 90%, 67% and 91%, respectively.

CONCLUSION

Using a higher cut-off value, can cause difficulties in diagnosis of patients with early MI. Since troponin results above the accepted threshold value can also be due to reasons other than MI, the increase or decrease between the series of measurements of troponin can be used to strengthen the idea of acute myocardial damage. For TnI, the more comprehensive prospective studies should be planned with detailed patient information to determine the lower cut-off value which provides the higher sensitivity, specificity and false positive and negative ratios are reduced.