[Value of human cardiac troponin I determination in the diagnosis of acute myocardial infarction].
Immunoenzymatic assay (IEMA) of human cardiac Troponin I (TnI c) was used in patients admitted to the coronary care unit with acute myocardial infarction (AMI). TnI c was detected in all patients with AMI. The detection of TnI c was earlier after the onset of pain (4.5 +/- 2.3 hours) than that of CKMB activity (6.3 +/- 3.6 hours), p = 0.003. The kinetics of TnI c are usually monophasic and parallel to that of CKMB activity. The peak value occurs 12.2 +/- 4.6 hours and 15.8 +/- 9.0 hours after the onset of pain in patients treated by thrombolysis. The TnI c disappears from the plasma between 5 and 9 days after the onset of pain, later than CKMB activity (p = 0.0001). In 49 patients admitted for AMI treated by thrombolysis, the comparative sensitivities of TnI c (threshold: 0.1 ng/ml) and of CKMB activity (threshold: 15 IU/l; CK > or = 100 Ul/l) were, at the first sampling on admission, 61% and 22% respectively (p = 0.0002) (average interval from onset of pain to first blood sampling: 3.4 +/- 1.3 hours). TnI c was not detected in the plasma of 145 normal subjects nor in any of the 6 patients with severe muscular trauma or rhabdomyolosis (specificity: 100%). This IEMA is a specific and a sensitive method of diagnosing acute and subacute myocardial infarction. It is ideal for the detection of myocardial necrosis in complex clinical situations when the usual enzymatic markers may be ineffective.
Bertinchant
J P
JP
Service de cardiologie, ERIA Diagnostics Pasteur, Marnes-La-Coquette.
Larue
C
C
Pernel
I
I
Beck
L
L
Bouges
S
S
Calzolari
C
C
Trinquier
S
S
Lamy
J P
JP
Paolucci
F
F
Pau
B
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000276:immunology; D015415:Biomarkers / Q000097:blood; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D007527:Isoenzymes; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000201:enzymology; D009211:Myoglobin / Q000097:blood; D009218:Myosins / Q000097:blood; D012680:Sensitivity and Specificity; D014336:Troponin / Q000097:blood*; D019210:Troponin I
D000911:Antibodies, Monoclonal; D015415:Biomarkers; D007527:Isoenzymes; D009211:Myoglobin; D014336:Troponin; D019210:Troponin I; D003402:Creatine Kinase; D009218:Myosins
Intérêt du dosage de la troponine I cardiaque humaine dans le diagnostic de l'infarctus aigu du myocarde.