Clinical chemistry
-
Comparative Study
Clinical performance of two highly sensitive cardiac troponin I assays.
The aim of this study was to compare the clinical performance of 2 sensitive cTnI assays with 10% CV imprecision below the 99th percentile upper reference limit. ⋯ The AccuTnI assay identified more patients at risk than the Centaur cTnI Ultra assay. Our results demonstrate the clinical potential of high-sensitivity cardiac troponin assays for the identification of patients at risk of dying from cardiovascular disease.
-
Plasma myeloperoxidase (MPO), an inflammatory biomarker, is associated with increased mortality in patients with acute coronary syndrome or chronic left ventricular systolic dysfunction. We sought to assess the diagnostic accuracy of MPO for acute decompensated heart failure (ADHF) and its prognostic value for patients with acute dyspnea. ⋯ Unlike natriuretic peptides, MPO concentration was not predictive of ADHF diagnosis or 1-year mortality in a heterogeneous sample of emergency department patients with acute dyspnea.
-
Endurance exercise can increase cardiac troponin (cTn) concentrations as high as those seen in cases of minor myocardial infarction. The inability of most cTn assays to reliably quantify cTn at very low concentrations complicates a thorough data analysis, and the clinical implications of such increases remain unclear. The application of recently developed highly sensitive cTn immunoassays may help resolve these problems. ⋯ The hs-cTnT assay was the only assay tested with a performance capability sufficient to detect cTn concentrations in healthy individuals. The number of runners with increased cTn concentrations after a marathon depends highly on an assay's limit of detection (LOD). The assay with the lowest LOD, the hs-cTnT assay, showed that almost all runners had increased cTn concentrations. The clinical implications of these findings require further investigation.
-
Cardiac troponin is the preferred biomarker for detecting acute myocardial injury and infarction (MI). We studied whether multiple biomarkers of numerous pathophysiological pathways would increase the diagnostic accuracy for detecting MI. ⋯ Our findings indicate that the most clinically accurate biomarker for the early diagnosis of MI is the use of cTnI alone, rather than a multiple-biomarker approach, when an analytically robust cardiac troponin assay based on the 99th percentile is used.