A. Falahati et al., Implementation of serum cardiac troponin I as marker for detection of acute myocardial infarction, AM HEART J, 137(2), 1999, pp. 332-337
Citations number
26
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Background The goal of this prospective study was to assess whether cardiac
troponin I (cTnI) could replace creatine kinase (CK)-MB mass as the serum
biochemical marker for detection of acute myocardial infarction (AMI).
Methods and Results over a 3-month period, 327 nonselected, consecutive pat
ients were evaluated for AMI with the use of modified World Health Organiza
tion criteria including serial electrocardiographs and CK-MB mass determina
tions at admission and 6, 12, and 24 hours after admission, cTnI measuremen
ts were also made at all time points. Sixty two (19%) patients were diagnos
ed with AMI. Diagnostic sensitivity and specificity for peak concentrations
were equivalent or better for cTnI (100%; 96.3%) compared with CK-MB (88.2
%; 93.2%) and total CK (73.5%; 84.6%), respectively. cTnI demonstrated 100%
negative predictive accuracy For ruling out AMI. Further, cTnI maintained
a high diagnostic sensitivity (>94%) up to 96 hours after onset of chest pa
in compared with CK-MB and total CK (both 50% sensitive) in patients with A
MI. However, patients with documented Q-wave infarctions had a significantl
y longer clearance compared with non-Q-wave infarctions (t1/2 24.2 vs 73 ho
urs, respectively; P < .01). There was a significant (P < .02) positive cor
relation (r = 0.89) between increasing CK-MB mass and increasing cTnI for A
MI specimens.
Conclusions These findings have strongly supported our clinical implementat
ion of cTnI, replacing CK-MB mass as the preferred marker for detection of
AMI.