title: Earlier detection of myocardial infarction by an improved cardiac TnI assay.
abstract: OBJECTIVE
  The aim of this study was to establish the diagnostic sensitivity of combinations of well-selected monoclonal antibodies (mAbs) against cardiac troponin I (cTnI) to allow an earlier rule-in of acute coronary syndrome (ACS) patients.
  
  
  METHODS
  Using several combinations of mAbs, four new experimental cTnI immunoassays were evaluated to analyze plasma samples from 62 patients suffering from angina (16/62), patients having a chest pain of extracardiovascular origin (19/62) and ACS without ST elevation (NSTE-ACS) (27/62).
  
  
  RESULTS
  Assay 2, which relies on a capture mAb directed against the central part of cTnI and two conjugated mAbs directed against the N-ter region, provided the best clinical sensitivity. In 11 out of 27 patients with NSTE-ACS, it detected an early rise of cTnI within 0 and 1 h upon admission, contributing to the detection of 53% of samples found to be negative by the reference AccuTnI Assay upon admission (Beckman Coulter), thereby reducing the delay in diagnosis.
  
  
  CONCLUSIONS
  Assay 2 can identify early cTnI elevation in NSTE-ACS, possibly facilitating the rule-in procedure for these patients once the assay is automated.
authors.affiliation: CNRS UMR 5160, Faculté de Pharmacie, BP 14491, 15 Avenue Charles Flahault, 34093 Montpellier Cedex 5, France.
authors.forename: Estelle
authors.initials: E
authors.lastname: Le Moal
authors.forename: Isabelle
authors.initials: I
authors.lastname: Giuliani
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Bertinchant
authors.forename: Anne
authors.initials: A
authors.lastname: Polge
authors.forename: Catherine
authors.initials: C
authors.lastname: Larue
authors.forename: Sylvie
authors.initials: S
authors.lastname: Villard-Saussine
mesh_terms: D000368:Aged; D000911:Antibodies, Monoclonal / Q000276:immunology; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007118:Immunoassay / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000378:metabolism*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D019210:Troponin I / Q000032:analysis* / Q000276:immunology
chemical_list: D000911:Antibodies, Monoclonal; D019210:Troponin I