Sažeci 2. Hrvatskog kongresa medicinske biokemije - Klinički zavod ...

Radionice
R2/1
USEFULNESS OF A NEW RAPID BEDSIDE TROPONIN
T ASSAY IN PATIENTS WITH CHEST PAIN
M.M. Hirschl
Department of Emergency Medicine, New General Hospital, Vienna, Austria
Objectives: We evaluated the usefulness of a rapid, qualitative,
bedside immunoassay, for cardiac-specific troponin T in patients with
chest pain.
Background: Cardiac-specific troponin T is a marker for myocardial
cell damage. Recently, a rapid qualitative bedside immunoassay
for troponin T has been developed. Methods: In 116 patients admitted
to the hospital with acute chest pain an electrocardiogram was
performed and blood samples were drawn to determine CK-MB and
troponin T qualitatively and quantitatively We evaluated the sensitivity
and specificity of the rapid troponin T assay for diagnosis of
acute myocardial infarction, the likelihood ratios of positive and negative
troponin T assay results and a comparison to CK-MB measurements
for diagnosis of myocardial infarction.
Results: A concordant result between quantitative troponin T and
qualitative troponin T assay was observed in 183 (96%) tests. The
sensitivity of the rapid troponin T assay for detecting acute myocardial
infarction increased significantly according to the number of hours
elapsed after onset of chest pain from 17% for patients presenting
within 4 hours to 71% for patients presenting in the time interval
greater than 8 hours from onset of chest pain (p < 0,001). Specificity
ranged from 83% to 93% in the three time intervals evaluated. A concordant
result between CK-MB measurement and rapid troponin T
assay was observed in 159 (83%) tests. In 14/191 tests a positive rapid
troponin T and a negative CK-MB assay was observed, in 9/14 (64%)
BIOCHEMIA MEDICA god. 6, br. 1, 1996 81