Diagnostic performance of one-hour delta high sensitive troponin in acute coronary syndrome

Abstract

Objective: To determine the impact of an increase in the level of high sensitivite (HS) troponin-I between the time of Emergency Department (ED) arrival and one-hour after arrival (0h-1h), and between the time of ED arrival and three hours after arrival (0h-3h), upon the diagnostic performance of HS troponin-I to correctly diagnose AMI. Study Design: Descriptive, analytical study. Place and Duration of Study: Fethi Sekin City Hospital, Elazig, Turkey from January to June 2019. Methodology: Patients presenting with chest pain were included in the study. The delta HS Troponin I (0h-1h) and delta HS Troponin I (0h-3h) values of the patients were calculated as percentage changes. These values were statistically compared between those who were diagnosed with acute myocardial infarction (AMI). Results: The evaluation was performed on 114 patients. Delta HS Troponin I levels were examined, a change of >20% was observed in 48 patients (42.1%) for the 0-1 hr interval. Of the 20 patients ultimately diagnosed with an AMI, 16 (80%) had such a change at this time (p <0.001). For 0-3 hr interval, a change of HS Troponin-I of >20% was observed in 52 patients (45.6%); and 17 of 20 AMI patients with an AMI were detected by such a change (p<0.001). Conclusion: Delta HS troponin I value in the first hour was nearly as sensitive for detection of an AMI as was delta HS Troponin I third-hour value.