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Sequential assessment of troponin in the diagnosis of myocardial infarction

Brandon Edwards1, Irsha Washington, Lester Pretlow

  • 1Department of Medical Laboratory, Imaging and Radiological Sciences, Georgia Regents University, Augusta, GA 30912, USA.

Clinical Laboratory Science : Journal of the American Society for Medical Technology
|June 19, 2013
PubMed

Insights

The initial cardiac troponin I (cTnI) assay is most critical for diagnosing acute myocardial infarction (AMI). Sequential troponin testing significantly improves AMI diagnostic accuracy.

Area of Science:

  • Cardiology
  • Biochemistry

Background:

  • Cardiovascular disease is a leading cause of death in the US.
  • Accurate and timely diagnosis of acute myocardial infarction (AMI) is crucial.

Purpose of the Study:

  • To identify the most critical time point for sample collection in diagnosing AMI.
  • To evaluate the diagnostic utility of sequential cardiac troponin I (cTnI) assays.

Main Methods:

  • Retrospective case-control study.
  • Binary multiple logistic regression modeling.
  • Analysis of sequential cTnI assays at four time points.

Main Results:

  • 78% of AMI cases were diagnosed at the initial time point (Tinitiai).
  • The initial cTnI assay was the most critical for AMI diagnosis.
  • Sequential troponin testing increased diagnostic ability by 10-fold.

Conclusions:

  • The initial cTnI assay is paramount for accurate AMI assessment.
  • Sequential troponin testing enhances the diagnostic capability for AMI.

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