title: Early detection of non-ST-elevation myocardial infarction in geriatric patients by a new high-sensitive cardiac troponin T assay.
abstract: OBJECTIVE
  The new high sensitivity cardiac Troponin T (cTnThs) assay has recently been introduced in our clinic and ensures higher sensitivity than the fourth-generation cardiac troponin T (cTnT) assay from the same manufacturer (Roche Diagnostics). We determined the diagnostic performance of the cTnThs compared with the cTnT assay in geriatric patients, especially those with non-ST elevation myocardial infarction (NSTE- MI).
  
  
  METHODS
  We retrospectively analysed 253 patients (age 82 ± 8 years; 82 men, 172 women) with diagnoses of suspected NSTEMI admitted to our Department of Geriatric Medicine. Patients were divided into one group of 113 patients using cTnThs, and another of 140 patients using cTnT for diagnosis. Each group included patients at the same months but different years, in either cTnThs or cTnT assays. NSTEMI was diagnosed according to current guidelines.
  
  
  RESULTS
  Baseline characteristics were similar in both groups. The proportions of patients with elevated cardiac troponin (cTn) levels significantly increased from 35% in the cTnT group to 76% in the cTnThs group (p<0.001), although no coronary cause for the elevated cTn levels was shown in about two-thirds of these patients. In patients with NSTE- MI, 58% in the cTnThs group vs 42% in the cTnT group were diagnosed within 4 hours of the onset of symptoms, whereas 42% in the cTnThs group vs 58% in the cTnT group were diagnosed more than 4 hours later (p=0.018).
  
  
  CONCLUSIONS
  The prevalence of elevated cTn has more than doubled with the use of cTnThs. However, no coronary cause was found in two-thirds of our geriatric patients, al- though more NSTEMI patients were diagnosed earlier by cTnThs.
authors.affiliation: Institute for Biomedicine of Ageing, Friedrich-Alexander-University Erlangen-Nuremberg, Germany. philipp.bahrmann@iba.fau.de
authors.forename: Philipp
authors.initials: P
authors.lastname: Bahrmann
authors.forename: Hans-Juergen
authors.initials: HJ
authors.lastname: Heppner
authors.forename: Michael
authors.initials: M
authors.lastname: Christ
authors.forename: Thomas
authors.initials: T
authors.lastname: Bertsch
authors.forename: Cornel
authors.initials: C
authors.lastname: Sieber
mesh_terms: D000369:Aged, 80 and over; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis*; D012189:Retrospective Studies; D020107:Troponin T / Q000097:blood*
chemical_list: D020107:Troponin T