Validation of a high sensitive troponin 99th percentile obtained in a general hospital.

High sensitivity cardiac Troponin T (hs-cTnT) dosage is recommended for myocardial infarction diagnosis, by applying the 99th percentile obtained from a healthy population by the manufacturer. The objective is to validate the 99th percentile in a population from our hospital (99L), compared with the...

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Detalles Bibliográficos
Autores principales: Martínez, María Laura, Bertazzo, Brunella Bianca, Gonzalez Grima, Juan, Figueroa Córdoba, Ana Virginia, Konicoff, Mailen, Martina, Luciana, Rossa, Victoria, Amuchastegui, Marcos, Brenna, Eduardo Javier, Salomone, Oscar, Ferrero Guadagnoli, Adolfo, Contreras, Alejandro Ernesto
Formato: Artículo revista
Lenguaje:Español
Publicado: Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2020
Materias:
Troponin T
myocardial infarction
validation studies
Troponina T
infarto de miocardio
estudios de validación
infarto do miocárdio
estudos de validação
Acceso en línea:https://revistas.unc.edu.ar/index.php/med/article/view/27473
Aporte de:
Revista de la Facultad de Ciencias Médicas de Córdoba de Universidad Nacional de Córdoba
Descripción
Sumario:High sensitivity cardiac Troponin T (hs-cTnT) dosage is recommended for myocardial infarction diagnosis, by applying the 99th percentile obtained from a healthy population by the manufacturer. The objective is to validate the 99th percentile in a population from our hospital (99L), compared with the manufacturer´s 99th percentile (99F) by using coronary angiography as gold standard.  Materials and method: Retrospective analysis of every hs-cTnT (Roche) obtained from patients admitted with acute coronary syndromes (ACS) who underwent coronary angiography between 2015 and 2018. Results: 415 patients were included for analysis (118 females, 64.2 yo). 99F sensitivity (Sn) for significant coronary artery disease (stenosis >70%) was 83.6%, with a specificity (Sp) of 44.5%. Positive predictive value (PPV) and negative predictive value (NPV) were 77% and 55% respectively. 99L Sn was 69.7% and Sp 58.6%. PPV was 79% and NPV 46%. ROC curve was 0.641 for 99F and 0.641 for 99L. Conclusion: Given the importance of hs-cTnT in ACS diagnosis, the 99F should be the preferred upper reference limit since the sensitivity is better, although lower compared to prior studies.

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