Diagnostic and Prognostic Performance of High-Sensitivity Cardiac Troponin T vs I

Abstract

Section snippets

Study design

This was a secondary analysis of the APACE (Advantageous Predictors of Acute Coronary Syndromes Evaluation; NCT00470587) study.⁷ For this analysis, we excluded patients with ST-segment elevation MI, patients in whom the diagnosis remained unclear even after final adjudication and had at least 1 elevated concentration of hs-cTnT/I, and patients with missing hs-cTnT or hs-cTnI measurements at presentation. The study was performed according to the principles of the Declaration of Helsinki and

Results

Among 7,614 patients (median age: 61 years [Q1-Q3: 48.0-73.0 years]; 34% women), 18.3% had MI when using hs-cTnT for adjudication and 17.3% when using hs-cTnI for adjudication, respectively.

Discussion

In this large prospective, international, multicenter study with external validation, we directly compared the diagnostic and prognostic performance of hs-cTnT and hs-cTnI.The main findings of this study were that hs-cTnI had a slightly higher diagnostic accuracy for MI and that hs-cTnT had higher prognostic accuracy for all-cause and CV death. These findings are of interest to clinicians because both assays are currently considered equivalent in both indications. Their underlying

Conclusions

hs-cTnT and hs-cTnI differ in their diagnostic and prognostic performance.

Funding Support and Author Disclosures

The APACE study was supported by research grants from the Swiss National Science Foundation, the Swiss Heart Foundation, the KTI, the University Hospital Basel, the University of Basel, Abbott, Beckman Coulter, Brahms, Idorsia, LSI Medience Corporation, Ortho Clinical Diagnostics, Quidel, Roche, Siemens, Singulex, and SpinChip Diagnostics. The BASEL VIII study was supported by research grants from the Swiss Heart Foundation, the KTI, the European Union, the University Hospital Basel, the

Acknowledgments

The authors are indebted to the patients who participated in the study and to the emergency department staff as well as the laboratory technicians of all participating sites for their most valuable efforts.