ROLE OF CARDIAC TROPONIN-I AS A DIAGNOSTI C-TEST IN CHEST PAIN APPROACH

Background and objectives. Cardiac troponin I is a highly sensitive an d specific myocardial injury marker. We have analyzed the use of cardi ac troponin I values in the diagnosis of coronary artery disease, in p reviously healthy patients who developed chest pain with inconclusive analytical and ECG diagnostic findings. Patients, material and methods . A one year cross-sectional consecutive study was conducted, in a tot -al of 37 patients with no previously known heart disease who were adm itted to the coronary unit for suspected anginal chest pain with norma l cardiac enzymes and EGG. Abnormal cardiac troponin I levels at admis sion were defined as greater than or equal to 0.4 ng/ml, and mere comp ared with coronary angiography or exercise test results and related to the duration of pain and the time from the appearance of symptoms to blood extraction. Results. Thirty-three of the 37 initially included p atients were studied. Coronary artery disease was diagnosed in 22, 15 of whom had increased troponin I values, yielding a sensitivity of 68% (48%-84%) and a specifity of 82%(53%-97%). In the subgroup of patient s with pain lasting > 30 min, sensitivity reached 85% (59%-97%) and sp ecifity 83% (42%-99%). There were no significant differences between s ubgroups with different time delays from appearance of symptoms to blo od extraction. Conclusions. Cardiac troponin I is very useful for the studying ischemic chest pain without a definitive diagnostic ECG nor b iochemical data, resulting in a high sensitivity and specifity for myo cardial ischemic injury detection. Its diagnostic value increases in c ases of prolonged pain episodes.