Variability of high-sensitivity troponin T concentrations in emergency settings : impact for the diagnosis of myocardial infarction.

Authors: Douville, PierreThériault, Sébastien
Abstract: Objectives: To assess biological variation of troponin T in emergency settings and establish limits for interpretation of serial results. Methods: We studied 6,557 consecutive patients with troponin measurements. A stable reference subset was selected to estimate biological variation and threshold limits. Results: The first troponin level was elevated in 32% of patients, and 2,490 had a second troponin level with a myocardial infarction (MI) prevalence of 16.2%. In the stable reference group with at least one abnormal value, the 99th percentile of the absolute delta between the first two samples was 16 ng/L. For MI diagnosis, the area under the receiver operating characteristic curve was 0.85 (confidence interval [CI], 0.83-0.87) for the first troponin level and 0.94 (CI, 0.93-0.95) for the absolute delta. Conclusions: An absolute delta of 16 ng/L has good specificity in the emergency setting. This threshold is valid for any sex, age, and sampling interval between 3 and 24 hours and is higher than published limits found in healthy outpatients.
Document Type: Article de recherche
Issue Date: 28 April 2018
Open Access Date: 23 July 2019
Document version: AM
This document was published in: American Journal of Clinical Pathology, Vol. 150 (1), 51–57 (2018)
American Society for Clinical Pathology
Alternative version: 10.1093/AJCP/AQY025
Collection:Articles publiés dans des revues avec comité de lecture

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