Diagnostic Performance of One-hour Delta High Sensitive Troponin in Acute Coronary Syndrome
1Department of Emergency Medicine, Balikesir University, Turkey.
Insights
A significant increase in high-sensitivity troponin-I levels within the first hour can help diagnose acute myocardial infarction (AMI), similar to a three-hour interval. This finding aids in the early detection of AMI.
Area of Science:
- Cardiology
- Clinical Diagnostics
Background:
- Acute myocardial infarction (AMI) diagnosis relies on sensitive biomarkers.
- High-sensitivity troponin-I (HS-Troponin-I) is crucial for detecting myocardial injury.
- Serial measurements of HS-Troponin-I are used to identify dynamic changes indicative of AMI.
Purpose of the Study:
- To evaluate the diagnostic performance of early (0-1 hour) and later (0-3 hour) changes in HS-Troponin-I levels for diagnosing AMI.
- To assess the impact of delta HS-Troponin-I on the accuracy of AMI detection.
Main Methods:
- A descriptive, analytical study was conducted.
- Patients presenting with chest pain were enrolled.
- Delta HS-Troponin-I values (0h-1h and 0h-3h) were calculated as percentage changes and compared between AMI and non-AMI groups.
Main Results:
- The study included 114 patients.
- A >20% increase in HS-Troponin-I within 0-1 hour was observed in 42.1% of patients, with 80% of AMI cases showing this change (p <0.001).
- A >20% increase in HS-Troponin-I within 0-3 hours was observed in 45.6% of patients, with 85% of AMI cases showing this change (p<0.001).
Conclusions:
- Early (1-hour) delta HS-Troponin-I is nearly as sensitive as the 3-hour value for detecting AMI.
- Serial HS-Troponin-I measurements in the emergency department can expedite AMI diagnosis.
Objective:
To determine the impact of an increase in the level of high sensitivite (HS) troponin-I between the time of Emergency Department (ED) arrival and one-hour after arrival (0h-1h), and between the time of ED arrival and three hours after arrival (0h-3h), upon the diagnostic performance of HS troponin-I to correctly diagnose AMI.
Study Design:
Descriptive, analytical study.
Place And Duration Of Study:
Fethi Sekin City Hospital, Elazig, Turkey from January to June 2019.
Methodology:
Patients presenting with chest pain were included in the study. The delta HS Troponin I (0h-1h) and delta HS Troponin I (0h-3h) values of the patients were calculated as percentage changes. These values were statistically compared between those who were diagnosed with acute myocardial infarction (AMI).
Results:
The evaluation was performed on 114 patients. Delta HS Troponin I levels were examined, a change of >20% was observed in 48 patients (42.1%) for the 0-1 hr interval. Of the 20 patients ultimately diagnosed with an AMI, 16 (80%) had such a change at this time (p <0.001). For 0-3 hr interval, a change of HS Troponin-I of >20% was observed in 52 patients (45.6%); and 17 of 20 AMI patients with an AMI were detected by such a change (p<0.001).
Conclusion:
Delta HS troponin I value in the first hour was nearly as sensitive for detection of an AMI as was delta HS Troponin I third-hour value. Key Words: Troponin, Myocardial infarction, Acute coronary syndrome.
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