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Validation and correlation of high-sensitive troponin I and troponin T in the emergency department

Nseir, Moustafa ; Mokhtari, Arash LU ; Stanisic, Mia ; Ekström, Ulf LU and Labaf, Ashkan LU (2024) In BMC Cardiovascular Disorders 24(1).
Abstract

Background: Troponin elevation is frequently observed in various scenarios in the Emergency Department (ED), yet there is a paucity of studies investigating simultaneously measured high-sensitivity cardiac troponin T (hs-cTnT) and troponin I (hs-cTnI) within a diverse cohort in a clinical setting. Methods: All patients who underwent troponin testing at a single center were eligible for this study. Only patients with simultaneous samples with hs-cTnI (Siemens) and hs-cTnT (Roche) were included, regardless of chief complaint. Results: Analysis of 1987 samples from 1134 patients showed a significant correlation between hs-cTnT and hs-cTnI (r = 0.86, p < 0.01). Of these samples, 65% exceeded the upper reference limit (URL) for hs-cTnT,... (More)

Background: Troponin elevation is frequently observed in various scenarios in the Emergency Department (ED), yet there is a paucity of studies investigating simultaneously measured high-sensitivity cardiac troponin T (hs-cTnT) and troponin I (hs-cTnI) within a diverse cohort in a clinical setting. Methods: All patients who underwent troponin testing at a single center were eligible for this study. Only patients with simultaneous samples with hs-cTnI (Siemens) and hs-cTnT (Roche) were included, regardless of chief complaint. Results: Analysis of 1987 samples from 1134 patients showed a significant correlation between hs-cTnT and hs-cTnI (r = 0.86, p < 0.01). Of these samples, 65% exceeded the upper reference limit (URL) for hs-cTnT, and 30% for hs-cTnI with 39% who exhibited elevated hs-cTnT levels alongside normal hs-cTnI levels. The area under the curve (AUC) for acute myocardial infarction (AMI) for the index visit was 0.80 (95% CI; 0.75–0.85) for hs-cTnT and 0.87 (95% CI; 0.83–0.91) for hs-cTnI. Sensitivity and specificity were 91% and 39% for hs-cTnT, and 80% and 80% for hs-cTnI. Positive predictive value (PPV) and negative predictive value (NPV) was 9.3% and 98.5% for hs-cTnT respectively, corresponding for hs-cTnI was 21.3% and 98.3% respectively. Hazard ratios for 1-year mortality were 1.52 (95% CI; 1.40–1.66) for hs-cTnT and 1.26 (95% CI; 1.18–1.34) for hs-cTnI. Conclusion: Elevated troponins above the URL were very common in this diverse cohort, particularly for hs-cTnT, which was twice as frequent compared to hs-cTnI, resulting in low specificity and PPV for AMI.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Correlation, Myocardial infarction, Prognosis, Sensitivity, Specificity, Troponin I, Troponin T
in
BMC Cardiovascular Disorders
volume
24
issue
1
article number
551
publisher
BioMed Central (BMC)
external identifiers
  • scopus:85206123567
  • pmid:39395935
ISSN
1471-2261
DOI
10.1186/s12872-024-04230-1
language
English
LU publication?
yes
id
6ee62dec-19fc-4bcd-9c91-b419e05801ef
date added to LUP
2024-11-26 13:54:13
date last changed
2025-07-09 08:33:20
@article{6ee62dec-19fc-4bcd-9c91-b419e05801ef,
  abstract     = {{<p>Background: Troponin elevation is frequently observed in various scenarios in the Emergency Department (ED), yet there is a paucity of studies investigating simultaneously measured high-sensitivity cardiac troponin T (hs-cTnT) and troponin I (hs-cTnI) within a diverse cohort in a clinical setting. Methods: All patients who underwent troponin testing at a single center were eligible for this study. Only patients with simultaneous samples with hs-cTnI (Siemens) and hs-cTnT (Roche) were included, regardless of chief complaint. Results: Analysis of 1987 samples from 1134 patients showed a significant correlation between hs-cTnT and hs-cTnI (r = 0.86, p &lt; 0.01). Of these samples, 65% exceeded the upper reference limit (URL) for hs-cTnT, and 30% for hs-cTnI with 39% who exhibited elevated hs-cTnT levels alongside normal hs-cTnI levels. The area under the curve (AUC) for acute myocardial infarction (AMI) for the index visit was 0.80 (95% CI; 0.75–0.85) for hs-cTnT and 0.87 (95% CI; 0.83–0.91) for hs-cTnI. Sensitivity and specificity were 91% and 39% for hs-cTnT, and 80% and 80% for hs-cTnI. Positive predictive value (PPV) and negative predictive value (NPV) was 9.3% and 98.5% for hs-cTnT respectively, corresponding for hs-cTnI was 21.3% and 98.3% respectively. Hazard ratios for 1-year mortality were 1.52 (95% CI; 1.40–1.66) for hs-cTnT and 1.26 (95% CI; 1.18–1.34) for hs-cTnI. Conclusion: Elevated troponins above the URL were very common in this diverse cohort, particularly for hs-cTnT, which was twice as frequent compared to hs-cTnI, resulting in low specificity and PPV for AMI.</p>}},
  author       = {{Nseir, Moustafa and Mokhtari, Arash and Stanisic, Mia and Ekström, Ulf and Labaf, Ashkan}},
  issn         = {{1471-2261}},
  keywords     = {{Correlation; Myocardial infarction; Prognosis; Sensitivity; Specificity; Troponin I; Troponin T}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Cardiovascular Disorders}},
  title        = {{Validation and correlation of high-sensitive troponin I and troponin T in the emergency department}},
  url          = {{http://dx.doi.org/10.1186/s12872-024-04230-1}},
  doi          = {{10.1186/s12872-024-04230-1}},
  volume       = {{24}},
  year         = {{2024}},
}