HAMBURG, Germany, Dec. 28 (UPI) -- A test for levels of troponin I -- a protein in muscle tissue -- may help rule-out a diagnosis of heart attack, or confirm one, German researchers say.
Dr. Till Keller of the University Heart Center Hamburg, Germany, and colleagues evaluated the diagnostic performance of the newly developed highly sensitive troponin I assay (test) compared with a contemporary troponin I assay.
The study included 1,818 patients with suspected acute coronary syndrome -- conditions such as heart attack or angina, or chest pain -- from 2007 to 2008. Twelve biomarkers, including highly sensitive troponin I and contemporary troponin I, were measured on admission and again after 3 and 6 hours.
Twenty-three percent had a final discharge diagnosis of acute heart attack. Using the 99th percentile cutoff, highly sensitive troponin I (biomarker) on admission had a sensitivity of 82.3 percent and negative predictive value of 94.7 percent; highly sensitive troponin I determined after 3 hours had a sensitivity of 98.2 percent with negative predictive value of 99.4 percent.
"Early identification of individuals at high and intermediate risk for myocardial ischemia -- insufficient blood flow to the heart muscle -- is crucial because they benefit the most from early and aggressive treatment," the study said. "Determination of highly sensitive troponin I and contemporary troponin I values 3 hours after admission to the emergency department with use of the 99th percentile cutoff provides an negative predictive value greater than 99 percent, potentially allowing a safe rule-out of heart attack."
The findings are published in the Journal of the American Medical Association.
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