Biochemia Medica, Vol. 25 No. 3, 2015.
Izvorni znanstveni članak
https://doi.org/10.11613/BM.2015.043
“Real life use” of troponin in the emergency department: a survey of over 3000 cases
Matteo Vidali
; Dipartimento di Scienze della Salute, Universita del Piemonte Orientale, Novara, Italy
Enrica Verzotti
; Dipartimento di Medicina Traslazionale, Universita del Piemonte Orientale, Novara, Italy
Nicole Cabraz
; Dipartimento di Medicina Traslazionale, Universita del Piemonte Orientale, Novara, Italy
Francesca Santi
; Dipartimento di Medicina Traslazionale, Universita del Piemonte Orientale, Novara, Italy
Alessia Puma
; Dipartimento di Medicina Traslazionale, Universita del Piemonte Orientale, Novara, Italy
Giorgio Bellomo
; Dipartimento di Scienze della Salute, Universita del Piemonte Orientale, Novara, Italy
Alessandro Lupi
; Cardiologia II, Azienda Ospedaliero Universitaria Maggiore della Carita, Novara, Italy
Giuseppe Lippi
; Laboratorio di Analisi Chimico-Cliniche ed Ematologiche, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
Gian Carlo Avanzi
; Dipartimento di Medicina Traslazionale, Universita del Piemonte Orientale, Novara, Italy
Sažetak
Introduction: The aim of this study was to identify clinical variables which may be independently associated with positivity of a cardiac troponin I (cTnI) assay in a large population of patients admitted to the emergency department (ED).
Materials and methods: 3166 subjects, with at least two troponin I tests ordered within 6 hours in the ED, were studied. Patient data were statistically analyzed to identify clinical associations with increased values of Troponin I.
Results: Although patients with diagnosis of acute coronary syndrome displayed troponin I values significantly higher than those of other groups, positivity to troponin I (> 40 ng/L) was also observed in patients with other clinical conditions. In multivariate analysis, age, elevated heart rate and electrocardiographyc changes were independently associated with troponin I positivity at admission. In the whole study population troponin I positivity exhibited high sensitivity and negative predictive value, counterbalanced by low specificity and limited positive predictive value.
Conclusions: Troponin I positivity should be combined with history and clinical evaluation and cautiously interpreted in the ED, especially in patients exhibiting factors associated with higher troponin I levels such as older age, elevated heart rate or ECG changes.
Ključne riječi
troponin I; acute coronary syndrome; emergency service, hospital; chest pain
Hrčak ID:
148687
URI
Datum izdavanja:
15.10.2015.
Posjeta: 806 *