Cinética temprana de troponina en pacientes con sospecha de infarto agudo de miocardio

Title in English	Early kinetics of cardiac troponin in suspected acute myocardial infarction
Authors	GIMENEZ M. R. WILDI K. WUSSLER D. KOECHLIN L. BOEDDINGHAUS J. NESTELBERGER T. BADERTSCHER P. SEDLMAYER R. PUELACHER C. ZIMMERMANN T. DE LAVALLAZ J. D. LOPEZ-AYALA P. LEU K. RENTSCH K. MIRO O. LOPEZ B. MARTIN-SANCHEZ F. J. BUSTAMANTE J. KAWECKI D. PAŘENICA Jiří LOHRMANN J. KLOOS W. BUSER A. KELLER D. I. REICHLIN T. TWERENBOLD R. MUELLER C.
Year of publication	2021
Type	Article in Periodical
Magazine / Source	REVISTA ESPANOLA DE CARDIOLOGIA
MU Faculty or unit	Faculty of Medicine
Citation
Web	https://www.sciencedirect.com/science/article/abs/pii/S0300893220302049?via%3Dihub
Doi	http://dx.doi.org/10.1016/j.recesp.2020.04.004
Keywords	Cardiac troponin release; Acute myocardial infarction; Linear release kinetics
Description	Introduction and objectives: Release kinetics of high-sensitivity cardiac troponin (hs-cTn) T and I in patients with acute myocardial infarction (AMI) are incompletely understood. We aimed to assess whether hs-cTnT/I release in early AMI is near linear. Methods: In a prospective diagnostic multicenter study the acute release of hs-cTnT and hs-cTnI within 1 and 2 hours from presentation to the emergency department was quantified using 3 hs-cTnT/I assays in patients with suspected AMI. The primary endpoint was correlation between hs-cTn changes from presentation to 1 hour vs changes from presentation to 2 hours, among all AMI patients and different prespecified subgroups. The final diagnosis was adjudicated by 2 independent cardiologists, based on serial hs-cTnT from the serial study blood samples and additional locally measured hs-cTn values. Results: Among 2437 patients with complete hs-cTnT data, AMI was the adjudicated diagnosis in 376 patients (15%). For hs-cTnT, the correlation coefficient between 0- to 1-hour change and 0- to 2 hour change was 0.931 (95%CI, 0.916-0.944), P < .001. Similar findings were obtained with hs-cTnI (Architect) with correlation coefficients between 0- to 1-hour change and 0- to 2 hour change of 0.969 and hs-cTnI (Centaur) of 0.934 (P < .001 for both). Findings were consistent among type 1 and type 2 AMI and in the subgroup of patients presenting very early after chest pain onset. Conclusions: Patients presenting with early AMI showed a near linear release of hs-cTnT and hs-cTnI. This near linearity provides the pathophysiological basis for rapid diagnostic algorithms using 0- to 1-hour changes as surrogates for 0- to 2 hour or 0- to 3 hour changes. Registered at ClinicalTrials.gov (Identifier: NCT00470587). (C) 2020 Sociedad Espanola de Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved.