title: Diagnostic value of high sensitive troponin T in chest pain patients with no persistent ST-elevations.
abstract: OBJECTIVE
  The aim of this study was to compare the early diagnostic value of the Roche high-sensitive troponin T (Hs-TnT) and that of conventional troponins.
  
  
  METHODS
  A total of 233 consecutive chest pain patients without ST-elevations were included. Hs-TnT was compared with two conventional assays (Roche troponin T [fourth generation] and Beckman Coulter Accu-TnI) on admission and at two hours.
  
  
  RESULTS
  When acute Myocardial Infarction (MI) was defined by conventional troponins and prespecified decision limits (Hs-TnT ≥ 14 ng/l, conventional TnT ≥ 0.04 μg/l, and Accu-TnI ≥ 0.06 μg/l) were used, Hs-TnT had a higher sensitivity but a lower specificity than conventional troponins both on admission and after two hours. When the biomarkers were compared in a ROC analysis there were no significant differences with regard to AUC. When acute MI was defined by Hs-TnT, the diagnostic performance of Hs-TnT remained very high (on admission: sensitivity 96%, specificity 85%, at two hours: sensitivity 99%, specificity 83%) whereas that of conventional troponins became lower, mainly because of lower sensitivity.
  
  
  CONCLUSIONS
  In conclusion, when acute MI is defined by a high sensitive troponin assay, the use of Hs-TnT improves the early diagnostic accuracy compared with conventional troponins. By measuring Hs-TnT it seems possible to exclude acute MI already within the first few hours from admission.
authors.affiliation: Section of Cardiology, Department of Medicine, Karolinska University Hospital, Huddinge Karolinska Institutet, Stockholm, Sweden. Dina.Melki@karolinska.se
authors.forename: Dina
authors.initials: D
authors.lastname: Melki
authors.forename: Suzanne
authors.initials: S
authors.lastname: Lind
authors.forename: Stefan
authors.initials: S
authors.lastname: Agewall
authors.forename: Tomas
authors.initials: T
authors.lastname: Jernberg
mesh_terms: D000368:Aged; D001681:Biological Assay / Q000379:methods; D015415:Biomarkers / Q000097:blood; D002637:Chest Pain / Q000097:blood*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014336:Troponin / Q000097:blood; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D014336:Troponin; D020107:Troponin T