HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) All Versions of this Article: clinchem.2008.106500v1 55/1/109    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Venge, P. Articles by Lindahl, B. Search for Related Content PubMed PubMed Citation Articles by Venge, P. Articles by Lindahl, B.

Clinical Performance of Two Highly Sensitive Cardiac Troponin I Assays

¹ Department of Medical Sciences, Clinical Chemistry, University of Uppsala; ² Department of Medical Sciences, Cardiology, University of Uppsala; ³ Uppsala Clinical Research Centre, University of Uppsala, Uppsala, Sweden; ⁴ Department of Clinical Chemistry, County Hospital of Gävle, Gävle, Sweden.

^aAddress correspondence to this author at: Department of Clinical Chemistry and Pharmacology, University Hospital, SE-751 85 Uppsala, Sweden. Fax +46186113703; e-mail per.venge{at}akademiska.se.

Background: 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.

Methods: We measured cardiac troponin and N-terminal pro-brain natriuretic peptide (NT-proBNP) concentrations in a random sample of the Global Use of Strategies To Open Occluded Coronary Arteries (GUSTO) IV cohort (n = 1251). Outcome data of 1-year mortality and the composite endpoint DMI [death and/or myocardial infarction (MI) within 30 days] were available in all patients. The 99th percentile of a healthy population was estimated from the Sweden Women and Men and Ischemic Heart Disease (SWISCH) cohort (n = 442). We measured cardiac troponin I (cTnI) using the Access AccuTnI (Beckman Coulter) and Centaur TnI Ultra (Siemens Healthcare Diagnostics) and NT-proBNP using the Elecsys 2010 (Roche Diagnostics).

Results: Applying the 10% CV cutoff, the sensitivity of the Access AccuTnI assay in identifying DMI and death was higher than that of the Centaur TnI Ultra (P = 0.02 and P < 0.001), and the AccuTnI assay also identified more patients at risk (P < 0.001) and with poor outcome. Applying the 99th percentile cutoffs, AccuTnI identified more patients at risk than the Centaur TnI (P < 0.001) and with significant differences in outcome. Significantly more patients with cardiac troponins below the cutoffs as measured by Centaur TnI had increased NT-proBNP concentrations (P < 0.001) compared with AccuTnI.

Conclusions: 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.

The following articles in journals at HighWire Press have cited this article:

				T. Keller, T. Zeller, D. Peetz, S. Tzikas, A. Roth, E. Czyz, C. Bickel, S. Baldus, A. Warnholtz, M. Frohlich, et al. Sensitive Troponin I Assay in Early Diagnosis of Acute Myocardial Infarction N. Engl. J. Med., August 27, 2009; 361(9): 868 - 877. [Abstract] [Full Text] [PDF]

				E. Kuhn, T. Addona, H. Keshishian, M. Burgess, D.R. Mani, R. T. Lee, M. S. Sabatine, R. E. Gerszten, and S. A. Carr Developing Multiplexed Assays for Troponin I and Interleukin-33 in Plasma by Peptide Immunoaffinity Enrichment and Targeted Mass Spectrometry Clin. Chem., June 1, 2009; 55(6): 1108 - 1117. [Abstract] [Full Text] [PDF]