Valor prognóstico da troponina I de alta sensibilidade versus troponina T nas síndromes coronarianas agudas

Lc, Correia; Fl, Sodré; Jc, Lima; Sabino, Michael; Brito, Mariana; Garcia, Guilherme; Maraux, Mayara; Ac, Sousa; Noya-Rabelo, Márcia; Jp, Esteves

doi:10.1590/s0066-782x2012005000034

Cited by 4 publications

(1 citation statement)

References 12 publications

(16 reference statements)

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“… 1 The cTn not only added agility to diagnostic confirmation, 2 , 3 but proved to be very useful in choosing between different therapeutic strategies 4 - 9 and in identifying patients at higher risk for future cardiovascular events. 10 , 11 …”

Section: Introductionmentioning

confidence: 99%

Serial High-Sensitivity Troponin T in Post-Primary Angioplasty Exercise Test

Vaz¹,

Vanz²,

Castro³

2016

Arquivos Brasileiros De Cardiologia

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BackgroundThe kinetics of high-sensitivity troponin T (hscTnT) release should be studied in different situations, including functional tests with transient ischemic abnormalities.ObjectiveTo evaluate the release of hscTnT by serial measurements after exercise testing (ET), and to correlate hscTnT elevations with abnormalities suggestive of ischemia.MethodsPatients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary angioplasty were referred for ET 3 months after infarction. Blood samples were collected to measure basal hscTnT immediately before (TnT0h), 2 (TnT2h), 5 (TnT5h), and 8 hours (TnT8h) after ET. The outcomes were peak hscTnT, TnT5h/TnT0h ratio, and the area under the blood concentration-time curve (AUC) for hscTnT levels. Log-transformation was performed on hscTnT values, and comparisons were assessed with the geometric mean ratio, along with their 95% confidence intervals. Statistical significance was assessed by analysis of covariance with no adjustment, and then, adjusted for TnT0h, age and sex, followed by additional variables (metabolic equivalents, maximum heart rate achieved, anterior wall STEMI, and creatinine clearance).ResultsThis study included 95 patients. The highest geometric means were observed at 5 hours (TnT5h). After adjustments, peak hscTnT, TnT5h/TnT0h and AUC were 59% (p = 0.002), 59% (p = 0.003) and 45% (p = 0.003) higher, respectively, in patients with an abnormal ET as compared to those with normal tests.ConclusionHigher elevations of hscTnT may occur after an abnormal ET as compared to a normal ET in patients with STEMI.

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Section: Introductionmentioning

confidence: 99%

Serial High-Sensitivity Troponin T in Post-Primary Angioplasty Exercise Test

Vaz¹,

Vanz²,

Castro³

2016

Arquivos Brasileiros De Cardiologia

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Comparison of high sensitive and conventional troponin assays in diagnosis of acute myocardial infarction

Işıksaçan

Bıyık

Ertürk

et al. 2017

Turkish Journal of Biochemistry

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Introduction:We aimed to compare the positive predictive values (PPV) and negative predictive values (NPV) of four cardiac troponin assays in the diagnosis of AMI in Turkish population.Methods:This study is an observational comparative study, which is performed between 2012 and 2013 (527 patients). Troponin levels were measured with chemiluminescence Cobas troponin T assay, immunofluorescence Triage troponin I assay and immunochromatographic Toyo troponin I assay.Results:Sensitivity and specificity of immunofluorometric assay (Radiometer) are 56.82% and 71.34%; immunochromatographic assay (Toyo) are 29.4% and 88.62%, immunofluorescence assay (Triage) are 47.13% and 76.12%, chemiluminescence assay (Roche) are 60.49 and 67.42%, respectively. PPV, NPV and positive likelihood ratios (LR+) of immunofluorometric assay (Radiometer) are 45.5%, 79.7% and 1.98, immunochromatographic assay (Toyo) are 51.5%, 75.4% and 2.58, immunofluorescence assay (Triage) are 46.5%, 76.6% and 1.97, chemiluminescence assay (Roche) are 45.8%, 78.9% and 1.86, respectively. In four assays, troponin levels were statistically significant higher in AMI positive group in comparison to negative group (p<0.001 for all).Conclusion:There was no statistically significant difference between these troponin methods in comparisons of PPV and NPV in the diagnosis of AMI, but low sensitivity of Triage and Toyo assays should be considered.

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Desempenho Diagnóstico da Angiotomografia Computadorizada e da Avaliação Seriada de Troponina Cardíaca Sensível em Pacientes com Dor Torácica e Risco Intermediário para Eventos Cardiovasculares

Soeiro¹,

Biselli²,

Leal³

et al. 2021

Arquivos Brasileiros De Cardiologia

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Fundamento: A angiotomografia coronária (ATC) tem sido usada para avaliação de dor torácica principalmente em pacientes de baixo risco, e poucos dados existem com pacientes em risco intermediário. Objetivo: Avaliar o desempenho de medidas seriadas de troponinas sensíveis e de ATC em pacientes de risco intermediário. Métodos: Um total de 100 pacientes com dor torácica, TIMI score 3 ou 4 e troponina negativa foram prospectivamente incluídos. Todos os pacientes foram submetidos à ATC, e aqueles com obstruções ≥ 50% foram encaminhados à cineangiocoronariografia. Pacientes com lesões < 50% recebiam alta hospitalar, receberam alta e foram contatados 30 dias depois por telefonema para avaliação dos desfechos clínicos. Os desfechos foram hospitalização, morte, e infarto agudo do miocárdio em 30 dias. A comparação entre os métodos foi realizada pelo teste de concordância kappa. O desempenho das medidas de troponina e da ATC na detecção de lesões coronárias significativas e desfechos clínicos foi calculado. Os resultados foram considerados estatisticamente significativos quando p <0,05.Resultados: Estenose coronária ≥ 50% na ATC foi encontrada em 38% dos pacientes e lesões coronárias significativas na angiografia coronária foram encontradas em 31 pacientes. Dois eventos clínicos foram observados. A análise de concordância Kappa mostrou baixa concordância entre as medidas de troponina e ATC na detecção de lesões coronárias significativas (kappa = 0,022, p = 0,78). O desempenho da ATC para detectar lesões coronárias significativas na angiografia coronária ou para prever eventos clínicos em 30 dias foi melhor que as medidas de troponina sensível (acurácia de 91% versus 60%).Conclusão: ATC teve melhor desempenho que as medidas seriadas de troponina na detecção de doença coronariana significativa em pacientes com dor torácica e risco intermediário para eventos cardiovasculares.

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Valor prognóstico da troponina I de alta sensibilidade versus troponina T nas síndromes coronarianas agudas

Abstract: Background: Despite superior diagnostic accuracy of high-sensitivity cardiac troponins, their prognostic value has not been validated against conventional cardiac troponins.

Cited by 4 publications

References 12 publications

Serial High-Sensitivity Troponin T in Post-Primary Angioplasty Exercise Test

Serial High-Sensitivity Troponin T in Post-Primary Angioplasty Exercise Test

Comparison of high sensitive and conventional troponin assays in diagnosis of acute myocardial infarction

Desempenho Diagnóstico da Angiotomografia Computadorizada e da Avaliação Seriada de Troponina Cardíaca Sensível em Pacientes com Dor Torácica e Risco Intermediário para Eventos Cardiovasculares

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