Clinical Research in Cardiology

, Volume 100, Issue 3, pp 209–215

Comparison of the new high sensitive cardiac troponin T with myoglobin, h-FABP and cTnT for early identification of myocardial necrosis in the acute coronary syndrome

  • Kerstin Kurz
  • Evangelos Giannitsis
  • Maike Becker
  • Georg Hess
  • Dietmar Zdunek
  • Hugo A. Katus
Original Paper

DOI: 10.1007/s00392-010-0230-y

Cite this article as:
Kurz, K., Giannitsis, E., Becker, M. et al. Clin Res Cardiol (2011) 100: 209. doi:10.1007/s00392-010-0230-y

Abstract

Background

We sought to determine the performance of the new high sensitivity cardiac troponin T assay (TnThs) for early diagnosis of myocardial infarction in patients with suspected acute coronary syndrome (ACS) and compare it with the fourth generation cTnT assay, myoglobin and heart-type fatty acid binding protein (h-FABP).

Methods

Ninety-four patients with diagnosis of suspected ACS without ST-segment elevation admitted to our chest pain unit were included. Patients were divided according to time from onset of symptoms to presentation into an early presenter group (<4 h) and a late presenter group (≥4 h). A median of six samples (range 2–8) were available per patient. The diagnostic performance of TnThs was assessed using ROC analysis. Areas under the curve (AUC) of baseline and follow-up results of TnThs, cTnT, myoglobin, and h-FABP were compared using c statistics.

Results

The TnThs assay allows an excellent prediction of non-ST-segment elevation myocardial infarction (non-STEMI) at presentation, particularly among late presenters. A follow-up sample improves diagnostic performance in a time-dependent manner. The AUC of TnThs was superior to cTnT at all time points. The performance of TnThs was at least as good as myoglobin and h-FABP at presentation and during follow-up.

Conclusions

A baseline sample of TnThs allows an earlier prediction of non-STEMI than the less sensitive and precise fourth generation cTnT assay. Probably, this excellent performance of TnThs at baseline and follow-up could obviate the need for other early markers of necrosis in future.

Keywords

High sensitive troponin TCardiac necrosisEarly detectionMyoglobinh-FABP

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Kerstin Kurz
    • 1
  • Evangelos Giannitsis
    • 1
  • Maike Becker
    • 1
  • Georg Hess
    • 2
  • Dietmar Zdunek
    • 2
  • Hugo A. Katus
    • 1
  1. 1.Medizinische Klinik, Abteilung für Innere Medizin IIIUniversitätsklinikum HeidelbergHeidelbergGermany
  2. 2.Roche Diagnostics GmbHPenzbergGermany