Author(s): Ross G, Bever FN, Uddin Z, Hockman EM
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Abstract This article describes the sensitivity and specificity of troponin I when compared to creatine kinase-MB (CK-MB) and electrocardiography (ECG) for diagnosing acute myocardial infarction (AMI). Two different lower levels for defining positive results with troponin I were evaluated. A retrospective study of 153 patients who presented to the emergency department of a community hospital supplied the pool of patients for this study. Patients included in this study were those for whom a CK-MB was ordered. The majority of these patients were evaluated for chest pain or symptoms suggesting an acute cardiac event. Of the 153 patients studied, CK-MB results were positive in 91 (59\%) patients; ECG revealed AMI in 72 (47\%) patients. There were 103 (67\%) patients who had either positive CK-MB or ECG results. Ninety (59\%) patients had a troponin I level greater than 2.0 ng/mL, and 18 (12\%) patients had a troponin I level between 0.6 and 2.0 ng/mL. Seven patients whose troponin I level was between 0.6 and 2.0 ng/mL had negative CK-MB and ECG results. Therefore, 11 patients with troponin I between 0.6 and 2.0 ng/mL had AMI. Five patients with positive troponin I results (> 2.0 ng/mL) had negative CK-MB and ECG results. When a troponin I level greater than 0.6 ng/mL was used as a positive value, compared to CK-MB and ECG using either time zero or time 6 hours, the sensitivity was 94\% and specificity was 81\%. When troponin I greater than 2.0 ng/mL was used to define a positive test, the sensitivity was 85\% and specificity was 91\% when compared to CK-MB and ECG.
This article was published in J Am Osteopath Assoc
and referenced in Journal of Clinical & Experimental Cardiology