Validation of a high sensitive troponin 99th percentile obtained in a general hospital.
DOI:
https://doi.org/10.31053/1853.0605.v77.n4.27473Keywords:
Troponin T, myocardial infarction, validation studiesAbstract
High sensitivity cardiac Troponin T (hs-cTnT) dosage is recommended for myocardial infarction diagnosis, by applying the 99th percentile obtained from a healthy population by the manufacturer. The objective is to validate the 99th percentile in a population from our hospital (99L), compared with the manufacturer´s 99th percentile (99F) by using coronary angiography as gold standard.
Materials and method:
Retrospective analysis of every hs-cTnT (Roche) obtained from patients admitted with acute coronary syndromes (ACS) who underwent coronary angiography between 2015 and 2018.
Results:
415 patients were included for analysis (118 females, 64.2 yo). 99F sensitivity (Sn) for significant coronary artery disease (stenosis >70%) was 83.6%, with a specificity (Sp) of 44.5%. Positive predictive value (PPV) and negative predictive value (NPV) were 77% and 55% respectively. 99L Sn was 69.7% and Sp 58.6%. PPV was 79% and NPV 46%. ROC curve was 0.641 for 99F and 0.641 for 99L.
Conclusion:
Given the importance of hs-cTnT in ACS diagnosis, the 99F should be the preferred upper reference limit since the sensitivity is better, although lower compared to prior studies.
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