Diagnostic value of a bedside test for cardiac troponin T in the patient with chest pain presenting to the emergency room.
Identification of patients with acute chest pain due to acute coronary syndrome is a common and difficult challenge for emergency physicians. A prospective study was conducted to assess the diagnostic value of a bedside test of cardiac troponin T in the emergency room setting. Forty-nine consecutive patients, who visited the emergency room within 6 hours of the onset of acute chest pain, were enrolled. Of the 26 patients who were ultimately diagnosed as having acute coronary syndrome, seven patients (27%) had positive cardiac troponin T assay results, whereas none of the patients without acute coronary syndrome had positive results (0%). For patients with acute coronary syndrome who presented later than 3 hours after the onset (n = 4), the test was positive in all cases (positive predictive value: 100%, negative predictive value: 100%, p < 0.01). However, the positive rate was only 14% for those who presented earlier than 3 hours after the onset (n = 22) (positive predictive value: 100%, negative predictive value: 47%, p = 0.84). In conclusion, bedside troponin T test results should be evaluated considering the time interval from the onset of chest symptoms.
Suzuki
M
M
Department of Emergency and Critical Care Medicine, School of Medicine, Keio University, Tokyo, Japan. suzuki@med.keio.ac.jp
Hori
S
S
Fujishima
S
S
Takatsuki
S
S
Nakamura
I
I
Kimura
H
H
Aoki
K
K
Aikawa
N
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002637:Chest Pain / Q000097:blood*; D003402:Creatine Kinase / Q000097:blood; D004562:Electrocardiography; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D007527:Isoenzymes; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis; D009206:Myocardium / Q000378:metabolism*; D011446:Prospective Studies; D020107:Troponin T / Q000097:blood*
D007527:Isoenzymes; D020107:Troponin T; D003402:Creatine Kinase