To assess the diagnostic accuracy of troponin I (TnI) elevation in patients with acute coronary syndrome (ACS) in the emergency department (ED). METHODS: We retrospectively studied 166 patients with elevated TnI and electrocardiographic (ECG) change consistent with non-ST-segment elevation myocardial infarction. They were transferred from the ED to our coronary care unit (CCU) to undergo coronary angiography. RESULTS: Significant coronary stenosis were identified in 101 (61%) of patients. The other 65 patients were found to have different cardiac diseases (n=52) and in 13 patients diagnoses were not even related to the cardiovascular system. Wall motion abnormalities were assessed by echocardiographic wall motion score index (WMSI). Positive predictive value (PPV) of TnI varied from 53 to 65% for higher progressive values of the biomarker. The following PPVs were then calculated: PPV(TnI+CK-MB)=64%; PPV(TnI+WMSI)=72%, PPV(TnI+CK-MB+WMSI)=74%. CONCLUSIONS: Abnormal values of TnI were detected in a variety of diseases not related to ACS. Even if troponin release indicates myocardial injury, it is not always synonymous with infarction or ischemia. A misinterpretation of TnI elevation may give rise to a diagnostic dilemma and cause unnecessary morbidity. An integration of biomarkers (TnI and CK-MB), ECG and WMSI will help identify false-positive ACS patients and avoid inappropriate admissions to CCU

Troponin I as a specific marker of myocardial injury:from theory to clinical practice in the diagnosis of acute coronary sindrome / BUCCIARELLI DUCCI, Chiara; Rasile, C; Proietti, P; Mancone, Massimo; Volponi, C; Vestri, Anna Rita; Fedele, Francesco. - In: CORONARY ARTERY DISEASE. - ISSN 0954-6928. - STAMPA. - 15(8):(2004), pp. 499-504.

Troponin I as a specific marker of myocardial injury:from theory to clinical practice in the diagnosis of acute coronary sindrome

BUCCIARELLI DUCCI, CHIARA;MANCONE, Massimo;VESTRI, Anna Rita;FEDELE, Francesco
2004

Abstract

To assess the diagnostic accuracy of troponin I (TnI) elevation in patients with acute coronary syndrome (ACS) in the emergency department (ED). METHODS: We retrospectively studied 166 patients with elevated TnI and electrocardiographic (ECG) change consistent with non-ST-segment elevation myocardial infarction. They were transferred from the ED to our coronary care unit (CCU) to undergo coronary angiography. RESULTS: Significant coronary stenosis were identified in 101 (61%) of patients. The other 65 patients were found to have different cardiac diseases (n=52) and in 13 patients diagnoses were not even related to the cardiovascular system. Wall motion abnormalities were assessed by echocardiographic wall motion score index (WMSI). Positive predictive value (PPV) of TnI varied from 53 to 65% for higher progressive values of the biomarker. The following PPVs were then calculated: PPV(TnI+CK-MB)=64%; PPV(TnI+WMSI)=72%, PPV(TnI+CK-MB+WMSI)=74%. CONCLUSIONS: Abnormal values of TnI were detected in a variety of diseases not related to ACS. Even if troponin release indicates myocardial injury, it is not always synonymous with infarction or ischemia. A misinterpretation of TnI elevation may give rise to a diagnostic dilemma and cause unnecessary morbidity. An integration of biomarkers (TnI and CK-MB), ECG and WMSI will help identify false-positive ACS patients and avoid inappropriate admissions to CCU
2004
04 Pubblicazione in atti di convegno::04d Abstract in atti di convegno
Troponin I as a specific marker of myocardial injury:from theory to clinical practice in the diagnosis of acute coronary sindrome / BUCCIARELLI DUCCI, Chiara; Rasile, C; Proietti, P; Mancone, Massimo; Volponi, C; Vestri, Anna Rita; Fedele, Francesco. - In: CORONARY ARTERY DISEASE. - ISSN 0954-6928. - STAMPA. - 15(8):(2004), pp. 499-504.
File allegati a questo prodotto
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/365551
 Attenzione

Attenzione! I dati visualizzati non sono stati sottoposti a validazione da parte dell'ateneo

Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus ND
  • ???jsp.display-item.citation.isi??? ND
social impact