METAANALYSIS IN CLINICAL-CHEMISTRY - VALIDATION OF CARDIAC TROPONIN-TAS A MARKER FOR ISCHEMIC HEART-DISEASES

Metaanalysis is a method that incorporates the pooling of previously p ublished results to produce more statistically significant results. We used metaanalysis to examine the role of a new cardiac marker, cardia c troponin T (cTnT), in patients with ischemic heart disease. Metaanal ysis of six articles and one abstract on cTnT showed that this marker was just as sensitive as creatine kinase MB isoenzyme (CK-MB) for the retrospective diagnosis of acute myocardial infarction (AMI) 12-48 h a fter onset but less specific. Most of these articles showed that cTnT was increased in non-AMI patients with unstable angina pectoris. In a metaanalysis of four papers, two abstracts, a letter, and an unpublish ed manuscript, we examined the prognostic role of cTnT in non-AMI card iac patients. For an unfavorable endpoint defined as cardiac death, AM I, or the need for coronary artery revascularization, the results demo nstrated that abnormal concentrations of cTnT were associated with a h igher risk for a poor outcome than were normal concentrations of cTnT. We also compared cTnT with CK-MB for risk stratification. Metaanalysi s will become an increasingly important tool for evaluating new tests as they become available.