Metaanalysis in clinical chemistry: validation of cardiac troponin T as a marker for ischemic heart diseases.
Metaanalysis is a method that incorporates the pooling of previously published results to produce more statistically significant results. We used metaanalysis to examine the role of a new cardiac marker, cardiac troponin T (cTnT), in patients with ischemic heart disease. Metaanalysis of six articles and one abstract on cTnT showed that this marker was just as sensitive as creatine kinase MB isoenzyme (CK-MB) for the retrospective diagnosis of acute myocardial infarction (AMI) 12-48 h after onset but less specific. Most of these articles showed that cTnT was increased in non-AMI patients with unstable angina pectoris. In a metaanalysis of four papers, two abstracts, a letter, and an unpublished manuscript, we examined the prognostic role of cTnT in non-AMI cardiac patients. For an unfavorable endpoint defined as cardiac death, AMI, or the need for coronary artery revascularization, the results demonstrated that abnormal concentrations of cTnT were associated with a higher risk for a poor outcome than were normal concentrations of cTnT. We also compared cTnT with CK-MB for risk stratification. Metaanalysis will become an increasingly important tool for evaluating new tests as they become available.
Wu
A H
AH
Clinical Chemistry Laboratory, Hartford Hospital, CT 06102, USA.
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PL
D015415:Biomarkers; D002624:Chemistry, Clinical / Q000706:statistics & numerical data*; D003402:Creatine Kinase; D006801:Humans; D007527:Isoenzymes; D009203:Myocardial Infarction / Q000175:diagnosis; D017202:Myocardial Ischemia / Q000175:diagnosis*; D009206:Myocardium / Q000737:chemistry*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014336:Troponin / Q000097:blood*; D020107:Troponin T
D015415:Biomarkers; D007527:Isoenzymes; D014336:Troponin; D020107:Troponin T; D003402:Creatine Kinase