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Disease Markers
Volume 2017, Article ID 4523096, 11 pages
https://doi.org/10.1155/2017/4523096
Research Article

A Rational Adoption of the High Sensitive Assay for Cardiac Troponin I in Diagnostic Routine

1Department of Diagnostic Services, ASST Valtellina e Alto Lario, Sondrio, Italy
2Central Laboratory, Hospital “Valduce”, Como, Italy
3Medical Scientific Liaison Europe, Abbott Diagnostics, Roma, Italy

Correspondence should be addressed to Claudio Galli; moc.ttobba@illag.oidualc

Received 5 February 2017; Revised 9 March 2017; Accepted 21 March 2017; Published 15 May 2017

Academic Editor: Silvia Angeletti

Copyright © 2017 Antonio Croce et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We describe the adoption of high sensitive troponin I (hsTnI) in clinical practice in two hospital settings in Italy. Samples from 426 consecutive patients (mean age 68.8 ± 17.0) admitted to the Emergency Department with a suspected acute coronary syndrome (ACS) have been tested at admittance and after 3 and 6 hours by contemporary TnI and hsTnI. Results have been compared to the final clinical diagnosis. Troponin was detectable in 68.6% by TnI and 89.9% by hsTnI. Since hsTnI has a lower threshold for females, 38/41 patients with positive values only by hsTnI were women. The correlation between the assays was very high (). A diagnosis of acute myocardial infarction (AMI) was made in 45 cases (10.5%). The negative and positive predictive values for a 50% troponin variation at 3 hours were 95.8% and 66.7% for hsTnI and 95.0% and 52.6% for TnI and at 6 hours 90.3% and 100% for hsTnI and 88.9% and 78.9% for TnI, respectively. Receiver operating characteristic (ROC) curve analysis demonstrated a greater efficiency by hsTnI at 3 hours versus 6 hours (AUC = 0.91 versus 0.72). The main benefits of hsTnI are the adoption of gender-specific 99th percentile and the shortening of time to decision.