An increasing body of evidence has demonstrated the value of strategies based on cardiac troponin I (cTnI) assays in the diagnosis, prognosis and monitoring of patients with acute coronary syndrome (ACS). We evaluated the performance and the practicability of 5 commercially available quantitative cTnI assays in patients with ACS.
Blood samples from 96 patients, 40 with and 56 without clinical evidence of myocardial injury, were collected 24-48 hours after admission and used for the evaluation. Cardiac TnI assays were performed using 5 different immunoanalyzers (Abbott AxSYM®, Dade Behring Stratus® II, Bayer Centaur®, Bayer ACS:180® and Diagnostic Products Corporation Immulite®). The sensitivity, specificity and positive and negative predictive values (PV) were calculated for all assays. For the practicability evaluation, the general and special features related to installation, routine operation, quality control and other various special parameters of each immunoanalyzer was evaluated (using the score of 1-5 for each parameter) and compared with those of the other analyzers.
The calculated sensitivity, specificity and positive and negative predicted values for all assays are shown below. The final scores for the performance evaluations for the Immulite®, AxSYM®, Stratus® II, Centour®, and ACS:180® were 77, 81, 66, 85 and 74/110, respectively.CONCLUSIONS: Cardiac troponin I assays have very high sensitivity, specificity and predictive values for myocardial injury. Among the evaluated systems, Immulite® had the highest performance value, Centaur® had the highest practicability value and the AxSYM® had the highest combined performance and practicability values for the cTnI measurement in patients with ACS.
ImmunoanalyzerSensitivitySpecificity(+) PV(−) PVImmulite100%100%100%100%AxSYM98%100%100%98%Centaur83%100%96%88%Stratus II100%97%96%100%ACS-18083%100%96%88%
S. Saadeddin, None.