High-Sensitivity Cardiac Troponin I Assay for Early Diagnosis of Acute Myocardial Infarction.


Journal

Clinical chemistry
ISSN: 1530-8561
Titre abrégé: Clin Chem
Pays: England
ID NLM: 9421549

Informations de publication

Date de publication:
07 2019
Historique:
received: 10 12 2018
accepted: 25 02 2019
pubmed: 17 4 2019
medline: 9 4 2020
entrez: 17 4 2019
Statut: ppublish

Résumé

The aim of this study was to validate the clinical performance of the Beckman Access high-sensitivity cardiac troponin I (hs-cTnI) assay. We enrolled patients presenting to the emergency department with symptoms suggestive of acute myocardial infarction (AMI). Final diagnoses were centrally adjudicated by 2 independent cardiologists with all clinical information including cardiac imaging twice: first, using serial hs-cTnT (Elecsys, primary analysis), and second, using hs-cTnI (Architect, secondary analysis) measurements in addition to the clinically used hs-cTn. hs-cTnI Access was measured at presentation and at 1 h. The primary objective was a direct comparison of diagnostic accuracy as quantified by the area under the ROC curve (AUC) of hs-cTnI Access vs the hs-cTnT Elecsys and hs-cTnI Architect assays. Secondary objectives included the derivation and validation of an hs-cTnI Access-specific 0/1-h algorithm. AMI was the adjudicated final diagnosis in 243 of 1579 (15.4%) patients. The AUC at presentation for hs-cTnI Access was 0.95 (95% CI, 0.94-0.96), higher than hs-cTnI Architect [0.92 (95% CI, 0.91-0.94; Diagnostic accuracy and clinical utility of the Beckman hs-cTnI Access assay are very high and at least comparable to Roche hs-cTnT and Abbott hs-cTnI assays.

Sections du résumé

BACKGROUND
The aim of this study was to validate the clinical performance of the Beckman Access high-sensitivity cardiac troponin I (hs-cTnI) assay.
METHODS
We enrolled patients presenting to the emergency department with symptoms suggestive of acute myocardial infarction (AMI). Final diagnoses were centrally adjudicated by 2 independent cardiologists with all clinical information including cardiac imaging twice: first, using serial hs-cTnT (Elecsys, primary analysis), and second, using hs-cTnI (Architect, secondary analysis) measurements in addition to the clinically used hs-cTn. hs-cTnI Access was measured at presentation and at 1 h. The primary objective was a direct comparison of diagnostic accuracy as quantified by the area under the ROC curve (AUC) of hs-cTnI Access vs the hs-cTnT Elecsys and hs-cTnI Architect assays. Secondary objectives included the derivation and validation of an hs-cTnI Access-specific 0/1-h algorithm.
RESULTS
AMI was the adjudicated final diagnosis in 243 of 1579 (15.4%) patients. The AUC at presentation for hs-cTnI Access was 0.95 (95% CI, 0.94-0.96), higher than hs-cTnI Architect [0.92 (95% CI, 0.91-0.94;
CONCLUSIONS
Diagnostic accuracy and clinical utility of the Beckman hs-cTnI Access assay are very high and at least comparable to Roche hs-cTnT and Abbott hs-cTnI assays.

Identifiants

pubmed: 30988172
pii: clinchem.2018.300061
doi: 10.1373/clinchem.2018.300061
doi:

Substances chimiques

Biomarkers 0
Troponin I 0
Troponin T 0

Banques de données

ClinicalTrials.gov
['NCT00470587']

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

893-904

Investigateurs

Joan Elias Walter (JE)
Ivo Strebel (I)
Nikola Kozhuharov (N)
Michael Freese (M)
Carolina Fuenzalida (C)
Claudia Stelzig (C)
Danielle M Gualandro (DM)
Eleni Michou (E)
Kathrin Meissner (K)
Caroline Kulangara (C)
Samyut Shrestha (S)
Gregor Fahrni (G)
Stefan Osswald (S)
Beatriz López (B)
Esther Rodriguez Adrada (ER)
Eva Ganovská (E)
Jens Lohrmann (J)
Wanda Kloos (W)
Jana Steude (J)
Andreas Buser (A)
Arnold von Eckardstein (A)
Beata Morawiec (B)
Damian Kawecki (D)
Ewa Nowalany-Kozielska (E)
Piotr Muzyk (P)
Nicolas Geigy (N)
Katharina Rentsch (K)

Informations de copyright

© 2019 American Association for Clinical Chemistry.

Auteurs

Jasper Boeddinghaus (J)

Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland.
Division of Internal Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.
GREAT network.

Thomas Nestelberger (T)

Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland.
GREAT network.

Raphael Twerenbold (R)

Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland.
GREAT network.

Luca Koechlin (L)

Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland.
Department of Cardiac Surgery, University Hospital Basel, University of Basel, Switzerland.

Mario Meier (M)

Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland.
GREAT network.

Valentina Troester (V)

Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland.
GREAT network.

Desiree Wussler (D)

Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland.
Division of Internal Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.
GREAT network.

Patrick Badertscher (P)

Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland.
GREAT network.
Division of Cardiology, University of Illinois at Chicago, Chicago, IL.

Karin Wildi (K)

Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland.
GREAT network.

Christian Puelacher (C)

Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland.
GREAT network.

Jeanne du Fay de Lavallaz (J)

Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland.
Division of Internal Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.
GREAT network.

Maria Rubini Giménez (M)

Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland.
GREAT network.

Tobias Zimmermann (T)

Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland.
GREAT network.

Benjamin Hafner (B)

Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland.
GREAT network.

Eliska Potlukova (E)

Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland.
Division of Internal Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.

Òscar Miró (Ò)

GREAT network.
Emergency Department, Hospital Clinic, Barcelona, Catalonia, Spain.

F Javier Martin-Sanchez (FJ)

GREAT network.
Servicio de Urgencias, Hospital Clínico San Carlos, Madrid, Spain.

Dagmar I Keller (DI)

Emergency Department, University Hospital Zurich, Zurich, Switzerland.

Tobias Reichlin (T)

Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland.
Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland.

Christian Mueller (C)

Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland; christian.mueller@usb.ch.
GREAT network.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH