Use of the bioMérieux VIDAS® troponin I ultra assay for the diagnosis of myocardial infarction and detection of adverse events in patients presenting with symptoms suggestive of acute coronary syndrome

Role of Monitoring Changes in Sensitive Cardiac Troponin I Assay Results for Early Diagnosis of Myocardial Infarction and Prediction of Risk of Adverse Events

“…Diagnostic specificity tends to be lower with the more analytically sensitive cTnI assays, as reflected in the 78% specificity at presentation we obtained for the VITROS ES assay. Although some medical specialists may have concern that the lower specificity confounds the diagnostic picture, we support the view that any amount of myocardial damage as detected by cTn signals an impaired clinical outcome for the patient (12,14 ). In the current study the increased cTnI values observed that were not indicative of MI were associated with other pathophysiologic processes, such as congestive heart failure, renal disease, drug toxicity, and cancer, which are well described in the literature and understood to be caused by different mechanisms than AMI.…”

Assessment of the Multiple-Biomarker Approach for Diagnosis of Myocardial Infarction in Patients Presenting with Symptoms Suggestive of Acute Coronary Syndrome

“…The studies that have been performed have compared either cTnT or cTnI against CK-MB and myoglobin (38 ). In the studies that have used the newer-generation cardiac troponin assays, the clinical sensitivities of cardiac troponin outperformed those of both myoglobin and CK-MB, findings that are consistent with the fact that increases in cardiac troponin concentration begin 2 to 4 h after the onset of ischemic symptoms (29,(35)(36)(37)(38). Thus, the use of analytically sensitive cardiac troponin assays at their 99th-percentile cutoff provides all of the diagnostic information required for evaluating patients who present with symptoms of possible acute ischemia.…”

“…Clinical guidelines have influenced manufacturers of cardiac troponin assays to improve their analytical characteristics at lower concentrations (31,32 ). Several studies have now demonstrated that the diagnostic accuracy of the newer-generation cardiac troponin assays provide clinical sensitivities of 68%-88% for samples obtained at presentation and clinical specificities of 68%-83% (29,(35)(36)(37).…”

“…Reports of biomarkers that address myocardial injury and dysfunction and that differentiate the pathophysiologies of inflammation, plaque vulnerability, and ischemic myocardium are appearing in increasing numbers (29,(35)(36)(37)(38). We previously published findings for this same biomarker set for detecting adverse outcomes over a 4-month follow-up period (23 ).…”

Estimation of Ischemia Modified Albumin (IMA) Levels in Patients with Acute Coronary Syndrome

“…The optimum cut-off point of 84.4 (U/mL) that was derived from ROC curve analysis was approximately equivalent to 85 (U/mL) as reported by others [20,21]. However, some studies have used higher values of 90 U/mL [22] and 93.5 U/mL [23]. This may reflect differences in baseline characteristics of our study population compared to those of the aforementioned studies.…”