Earlier detection of myocardial infarction by an improved cardiac TnI assay.
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.
Le Moal
Estelle
E
CNRS UMR 5160, Faculté de Pharmacie, BP 14491, 15 Avenue Charles Flahault, 34093 Montpellier Cedex 5, France.
Giuliani
Isabelle
I
Bertinchant
Jean-Pierre
JP
Polge
Anne
A
Larue
Catherine
C
Villard-Saussine
Sylvie
S
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
D000911:Antibodies, Monoclonal; D019210:Troponin I