Clinical Research in Cardiology

, Volume 101, Issue 10, pp 837–845

Diagnostic and prognostic performance of a novel high-sensitivity cardiac troponin T assay compared to a contemporary sensitive cardiac troponin I assay in patients with acute coronary syndrome

  • M. Mueller
  • S. Celik
  • M. Biener
  • M. Vafaie
  • K. Schwoebel
  • K. C. Wollert
  • J. L. Januzzi
  • H. A. Katus
  • E. Giannitsis
Original Paper

DOI: 10.1007/s00392-012-0469-6

Cite this article as:
Mueller, M., Celik, S., Biener, M. et al. Clin Res Cardiol (2012) 101: 837. doi:10.1007/s00392-012-0469-6

Abstract

Objective

The study sought to compare the clinical performance of two more sensitive cardiac troponin (cTn) assays, a novel high-sensitivity (hs) troponin T assay and a contemporary cTnI assay.

Methods

We measured hs-cTnT (Roche TnThs) and cTnI (Siemens Centaur Ultra) on presentation in 1,384 patients with suspected acute coronary syndrome (ACS) who underwent early invasive strategy within 24 h after presentation. Kaplan–Meier, Cox proportional hazards, and receiver-operating characteristic (ROC) analysis was used to compare their prognostic performance for the prediction of all-cause death and death/MI (myocardial infarction) after a median of 271 days. We also compared the diagnostic performance of these assays on presentation for early diagnosis of non-STEMI.

Results

Both hs-cTnT and cTnI were independently predictive of long-term death (OR 3.51 vs. 2.19) and the composite of death/MI (OR 9.24 vs. 3.61), across the spectrum of ACS and in patients without ACS. When used as a continuous variable, ROC analysis demonstrated significantly higher areas under the curve (AUC) for hs-cTnT as compared to cTnI for the prediction of death/MI (0.721 vs. 0.672, P = 0.024), a trend to better prediction of all-cause death (0.721 vs. 0.672, P = 0.093) and significantly higher AUC for early diagnosis of non-STEMI (0.965 vs. 0.901, P < 0.001).

Conclusion

Using the 99th percentile cutoff for hs-cTnT and cTnI, both assays enable prediction of adverse long-term outcomes and earlier diagnosis of non-STEMI. Used as a continuous variable, the hs-cTnT assay showed superior performance compared to the cTnI assay, especially in regard to prognosis.

Keywords

High-sensitivity troponinAcute coronary syndromePrognosisEarly diagnosis

Supplementary material

392_2012_469_MOESM1_ESM.doc (23 kb)
Online Resource 1 (DOC 23 kb)
392_2012_469_MOESM2_ESM.ppt (151 kb)
Online Resource 2 (PPT 154 kb)
392_2012_469_MOESM3_ESM.ppt (70 kb)
Online Resource 3 (PPT 72 kb)
392_2012_469_MOESM4_ESM.ppt (54 kb)
Online Resource 4 (PPT 57 kb)
392_2012_469_MOESM5_ESM.ppt (68 kb)
Online Resource 5 (PPT 64 kb)

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • M. Mueller
    • 1
  • S. Celik
    • 1
  • M. Biener
    • 1
  • M. Vafaie
    • 1
  • K. Schwoebel
    • 1
  • K. C. Wollert
    • 2
  • J. L. Januzzi
    • 3
  • H. A. Katus
    • 1
  • E. Giannitsis
    • 1
  1. 1.Medizinische Klinik, Abteilung für Innere Medizin IIIUniversitätsklinikum HeidelbergHeidelbergGermany
  2. 2.Klinik für Kardiologie und AngiologieMedizinische Hochschule HannoverHannoverGermany
  3. 3.Cardiology DivisionMassachusetts General HospitalBostonUSA