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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Greaves, Ronda / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter

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Volume 51, Issue 9


Evaluation of four sensitive troponin assays for risk assessment in acute coronary syndromes using a new clinically oriented approach for comparison of assays

Bertil Lindahl
  • Corresponding author
  • Department of Medical Sciences, University of Uppsala, Sweden
  • Uppsala Clinical Research Center, University Hospital, 751 85 Uppsala, Sweden
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Kai M. Eggers / Per Venge / Stefan James
Published Online: 2013-04-06 | DOI: https://doi.org/10.1515/cclm-2013-0023


Background: Measurement of cardiac troponin T or I (cTnT; cTnI) is useful for risk prediction in acute coronary syndromes. The objective of the present study was to compare the prognostic capacity of four sensitive cardiac troponin assays using a new method for comparison.

Methods: Cardiac troponin was analyzed in serum samples from 1335 patients with acute coronary syndrome using the Elecsys high sensitivity TnT (hs-cTnT), ARCHITECT STAT high sensitivity TnI (hs-cTnI), Access AccuTnI (Acc-cTnI) and Architect cTnI (Arc-cTnI) assays. All patients were followed for 30 days regarding death and acute myocardial infarction (AMI), and for 1 year regarding mortality.

Results: By receiver operating characteristic (ROC) curve analyses, there were only minor differences in the area under the curves (AUC) between the assays. At a given sensitivity of 85% the hs-cTnT, Arc-cTnI and Acc-cTnI assays showed comparable specificities, while 90% or higher sensitivity was only possible to achieve with the hs-cTnT, hs-cTnI and Acc-cTnI assays. The highest odds ratios for death/AMI at 30 days and death at 1 year, respectively, were reached by cut-off levels yielding 95% sensitivity; these cut-off levels were below the respective 99th percentile levels.

Conclusions: By the adoption of a new method for the comparison of cardiac troponin assays we showed that the hs-cTnT, hs-cTnI and Acc-cTnI assays had comparable prognostic properties, while the Arc-cTnI assay had inferior prognostic sensitivity.

This article offers supplementary material which is provided at the end of the article.

Keywords: acute coronary syndromes; prognosis; troponin


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About the article

Corresponding author: Bertil Lindahl, Uppsala Clinical Research Center, University Hospital, 751 85 Uppsala, Sweden, Phone: +46 186119505, Fax: +46 18515570

Received: 2013-01-07

Accepted: 2013-03-15

Published Online: 2013-04-06

Published in Print: 2013-09-01

Citation Information: Clinical Chemistry and Laboratory Medicine, Volume 51, Issue 9, Pages 1859–1864, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/cclm-2013-0023.

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