Comparison of high sensitive and conventional troponin assays in diagnosis of acute myocardial infarction

Nilgün Işıksaçan 1 , İsmail Bıyık 2 , Mehmet Ertürk 3 , Murat Koşer 4 , Hüseyin Karakurt 3 , Begüm Özalp 3 , Ömer Faruk Baycan 3 , Mehmet Rıfat Yıldırım 3 , Serkan Yazan 3  and İbrahim Faruk Aktürk 3
  • 1 Bakirkoy Dr. Sadi KonUK Education and Research Hospital – Department of Biochemistry, İstanbul, Turkey
  • 2 USAk State Hospital Heart Center – Department of Cardiology, Uşak, Turkey
  • 3 Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital – Department of Cardiology, İstanbul, Turkey
  • 4 Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital – Department of Biochemistry, İstanbul, Turkey
Nilgün Işıksaçan, İsmail Bıyık, Mehmet Ertürk, Murat Koşer, Hüseyin Karakurt, Begüm Özalp, Ömer Faruk Baycan, Mehmet Rıfat Yıldırım, Serkan Yazan and İbrahim Faruk Aktürk

Abstract

Introduction:

We aimed to compare the positive predictive values (PPV) and negative predictive values (NPV) of four cardiac troponin assays in the diagnosis of AMI in Turkish population.

Methods:

This study is an observational comparative study, which is performed between 2012 and 2013 (527 patients). Troponin levels were measured with chemiluminescence Cobas troponin T assay, immunofluorescence Triage troponin I assay and immunochromatographic Toyo troponin I assay.

Results:

Sensitivity and specificity of immunofluorometric assay (Radiometer) are 56.82% and 71.34%; immunochromatographic assay (Toyo) are 29.4% and 88.62%, immunofluorescence assay (Triage) are 47.13% and 76.12%, chemiluminescence assay (Roche) are 60.49 and 67.42%, respectively. PPV, NPV and positive likelihood ratios (LR+) of immunofluorometric assay (Radiometer) are 45.5%, 79.7% and 1.98, immunochromatographic assay (Toyo) are 51.5%, 75.4% and 2.58, immunofluorescence assay (Triage) are 46.5%, 76.6% and 1.97, chemiluminescence assay (Roche) are 45.8%, 78.9% and 1.86, respectively. In four assays, troponin levels were statistically significant higher in AMI positive group in comparison to negative group (p<0.001 for all).

Conclusion:

There was no statistically significant difference between these troponin methods in comparisons of PPV and NPV in the diagnosis of AMI, but low sensitivity of Triage and Toyo assays should be considered.

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Turkish Journal of Biochemistry (TJB), official journal of Turkish Biochemical Society, is issued electronically every 2 months. The main aim of the journal is to support the research and publishing culture by ensuring that every published manuscript has an added value and thus providing international acceptance of the “readability” of the manuscripts published in the journal.

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