title: Diagnostic Role of High-Sensitivity Cardiac Troponin T in Acute Myocardial Infarction and Cardiac Noncoronary Artery Disease.
abstract: OBJECTIVE
  Currently, the distinction between AMI and cardiac noncoronary artery disease (CNCD) remains a challenge in clinical practice. Our aim was to evaluate the diagnostic role of high-sensitivity cardiac troponin T (hs-cTnT) level at presentation and its change within the first hour to distinguish AMI from CNCD.
  
  
  METHODS
  hs-cTnT was measured at presentation and after 1 h in 110 consecutive Chinese patients with symptoms suggestive of AMI within 12 h from symptom onset. Receiver-operating characteristics (ROC) analysis was used to estimate the diagnostic accuracy of hs-cTnT.
  
  
  RESULTS
  Patients with AMI had higher presentation values of hs-cTnT and higher absolute changes in the first h than patients with CNCD. The diagnostic accuracy of hs-cTnT at presentation for the distinction between patients with AMI and CNCD as quantified by the area under the receiver-operating characteristics curve (AUC) was 0.88. The discriminatory power of Δhs-cTnT 0-1 h was higher for absolute (AUC, 0.89; 95% CI, 0.83-0.94) compared to relative (AUC, 0.64; 95% CI, 0.60-0.73) changes. Combining presentation values of hs-cTnT at presentation with absolute changes in the first h increased the AUC to 0.93 (p < 0.001 for comparison with AUC of 0 h hs-cTnT).
  
  
  CONCLUSIONS
  Overall, our results suggest that the combined use of presentation values of hs-cTnT and its absolute change in the first hour discriminates well between patients with AMI and CNCD, further confirming the role of hs-cTnT as a biomarker for the early diagnosis of AMI.
authors.affiliation: First Affiliated Hospital of PLA General Hospital, Emergency Department, Hai Dian District, Beijing, China.
authors.forename: Qin
authors.initials: Q
authors.lastname: Su
authors.affiliation: First Affiliated Hospital of PLA General Hospital, Emergency Department, Hai Dian District, Beijing, China.
authors.forename: Yingfei
authors.initials: Y
authors.lastname: Guo
authors.affiliation: First Affiliated Hospital of PLA General Hospital, Emergency Department, Hai Dian District, Beijing, China.
authors.forename: Hongsheng
authors.initials: H
authors.lastname: Liu
authors.affiliation: First Affiliated Hospital of PLA General Hospital, Emergency Department, Hai Dian District, Beijing, China.
authors.forename: Yuhong
authors.initials: Y
authors.lastname: Qin
authors.affiliation: First Affiliated Hospital of PLA General Hospital, Emergency Department, Hai Dian District, Beijing, China.
authors.forename: Jianbo
authors.initials: J
authors.lastname: Zhang
authors.affiliation: First Affiliated Hospital of PLA General Hospital, Emergency Department, Hai Dian District, Beijing, China.
authors.forename: Xiaoling
authors.initials: X
authors.lastname: Yuan
authors.affiliation: First Affiliated Hospital of PLA General Hospital, Emergency Department, Hai Dian District, Beijing, China. Electronic address: zhaoxiaodongwy@163.com.
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Zhao
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D005260:Female; D006331:Heart Diseases / Q000097:blood / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis*; D011446:Prospective Studies; D012372:ROC Curve; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D020107:Troponin T
keywords: Acute myocardial infarction; Cardiac noncoronary artery disease; High-sensitivity cardiac troponin T; Receiver-operating characteristics