R. Gust et al., BEDSIDE TROPONIN-T TESTING IS NOT USEFUL FOR EARLY OUT-OF-HOSPITAL DIAGNOSIS OF MYOCARDIAL-INFARCTION, Acta anaesthesiologica Scandinavica, 42(4), 1998, pp. 414-417
Background: A new commercially available rapid qualitative bedside imm
unoassay for cardiac troponin T has been developed. The aim of the stu
dy was to investigate whether this new rapid bedside cardiac troponin
T assay facilitates diagnosing myocardial infarction in a pre-hospital
setting. Methods: We evaluated the sensitivity and specificity of the
new rapid bedside troponin T assay for myocardial infarction. In 68 p
atients with acute, central, crushing chest pain, who were strongly su
spected of having myocardial infarction, the emergency doctor performe
d preclinically a bedside cardiac troponin T test. The results were co
mpared with the diagnosis after admission to hospital, using the crite
ria of the World Health Organization. Results: The diagnosis of myocar
dial infarction was confirmed in 16/68 (24%) patients after admission
to hospital, but only in 4/16 (25%) patients with myocardial infarctio
n was a positive result observed preclinically with this test. The res
ult was false positive in 1/5 patients (20%). Conclusions: In contrast
to an excellent specificity (0.98), sensitivity (0.25) of the rapid t
roponin T assay was poor. Thus, we conclude that this test cannot impr
ove the distinction between myocardial infarction and angina pectoris
in a pre-hospital setting.