Shabina Saifullah, Mian Ehsan, Salma Khalid, Jehan Zeb.
Direct comparison of high-sensitivity cardiac troponin I versus conventional troponin I for the early diagnosis of non-st elevation myocardial infarction.
Pak Heart J Jan ;52(1):4-9.

Objective: To determine and compare the diagnostic value of high-sensitivity cardiac troponin I with conventional troponin I for the detection of non ST elevation acute myocardial Infarction (NSTEMI) in patients with chest pain. Methodology: This is a cross sectional study done in two tertiary care hospitals Peshawar KPK from August 2016 to February 2017. Patients were enrolled according to the inclusion criteria of the study. In this study direct comparison of the two assays was done in making the diagnosis of NSTEMI in patients with acute chest pain and to assess the diagnostic utility of the assays used. The method used is Electro Chemiluminescene immunoassay "ECLIA" which is carried out on Elecsys and Cobase immunoassay analyzers (ROCHE Diagnostics) for conventional cardiac troponin I (cTnI) and The Architect STAT High troponin I (Abbott Diagnostic) for hs-cTnI. Results: Sample size was calculated according to the kit used for detection of high-sensitivity troponin I and conventional troponin I sufficient for 100 samples. Therefore 86 patients sample size was selected and the rest of tests (14) were used for calibration and control. The study consisted of 86 patients with chest pain typical of acute coronary syndrome and ST-depression on electrocardiogram. The mean age of the patients was 59.21 +- 10.63 years. Of these 44 (51.1%) were females. There were 43 (50%) patients with positive history and 43 (50%) were with no history of ischemic heart disease. In this study 47(54.6%) patients were non-hypertensive, 43 (50%) were overweight, 5 (5.8%)were class 1 obese and only 1 (1.2%) was class 2 obese. About 48 were diagnosed as NSTEMI and 38 were diagnosed as unstable angina. The sensitivity of the cTnI for diagnosing NSTEMI was 60%, specificity was 89.1% with PPV of 82.7% and NPV of 72% and sensitivity of hs-cTnI for making diagnosis of NSTEMI was 94%, specificity was 92% with a PPV of 93.7% and NPV of 92.1%. Conclusion: This study concludes that high- sensitivity cardiac troponin I assay has more diagnostic utility when compared with conventional troponin I assay.

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