Title: Could Troponin I Elevations Predict Acute Myocardial Infarction? A 3-Year Retrospective Analysis of Acute Myocardial Infarction Patients at a Taiwan Hospital
Abstract: Objective: The purpose of this study is to establish a clinically applicable cut off value of troponin Ⅰ that can be used for determining the early diagnosis in patients with acute myocardial infarction (AMI) in the emergency department. Methods: The medical records of 5,624 emergency admission patients with chest pain and clinically suspected acute coronary syndrome (ACS) were enrolled consecutively in this study between Mar 2003 and Feb 2005 at the Changhua Christian Hospital. The final diagnoses were based on what was recorded on the discharge notes. Detailed laboratory data were from the department of laboratory medicine. The criterion for admission was a troponin measurement larger than 0.04mg/L, in addition to initial clinical impression of ACS. Receiver operator characteristic analyses were performed to determine cut off points of troponin Ⅰ in prediction of AMI. Results: A total of 256 patients (256/5624) were diagnosed with AMI upon discharge. Their mean age was 75.57 years. The 5 variables associated with the diagnosis were age, CPK, CK-MB, GPT, and troponin Ⅰ. The best cut off point revealed by the ROC curve of troponin Ⅰ was 0.042 mg/L; at which the sensitivity was 0.824 and the specificity was 0.816 when used for differential diagnosis. Conclusion: We recommend that the cut off value of troponin Ⅰ level at 0.042 mg/L may serve as a predictive parameter in the diagnosis of AMI.
Publication Year: 2006
Publication Date: 2006-06-01
Language: en
Type: article
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