Myocardial Infarction could now be more accurately detected

Acute inferior myocardial infarctionResearchers have developed a very much accurate method for early detection of heart attack a.k.a Myocardial Infarction.

This research has been done by the researchers from Germany’s University Heart Center Hamburg and published online in December 28 issue of the The Journal of American Medical Association.

Although, the researchers used the same protein, troponin I, which is a better biomarker of heart attack than any other protein yet found, for early detection of heart attack (already in use in conventional tests) but in this new version of high-sensitive troponin I (hsTnI) assay, researchers have gotten about 99% of accurate results in 1818 patients with acute chest pain and in whom several biomarker tests were conducted at the time of admission and at 3 and 6 hours of admission. According to the researchers, this will not only improve but also speed up the early diagnosis of acute Myocardial Infarction.

“Combining the 99th percentile cutoff at admission with the serial change in troponin concentration within 3 hours, the positive predictive value (for ruling in AMI) for hsTnI increased from 75.1 percent at admission to 95.8 percent after 3 hours, and for cTnl increased from 80.9 percent at admission to 96.1 percent after 3 hours,” the authors write.

“The shortcoming of conventional troponin assays with low sensitivity within the first hours after chest pain onset led to the evaluation of various so-called early biomarkers in the diagnosis of MI. In our study, the diagnostic information of hsTnI was superior to all other evaluated biomarkers alone.”

“Use of hsTnI and cTnI assays in patients with suspected MI provides useful diagnostic information,” the researchers write. “Determination of hsTnI and cTnI values 3 hours after admission to the emergency department with use of the 99th percentile cutoff provides an NPV greater than 99 percent, potentially allowing a safe rule-out of MI. Application of the relative change in hsTnI or cTnI concentration within 3 hours after admission in combination with the 99th percentile diagnostic cutoff value on admission improves specificity and may facilitate an accurate early rule-in of MI.”

According to the researchers, this new test is very much sensitive and can lead to over-diagnosis of heart attacks as very low blood concentrations of protein could be detected in the blood.

Reference:

Till Keller, MD; Tanja Zeller, PhD; Francisco Ojeda, PhD; Stergios Tzikas, MD; Lars Lillpopp; Christoph Sinning, MD; Philipp Wild, MD; Sabine Genth-Zotz, MD; Ascan Warnholtz, MD; Evangelos Giannitsis, MD; Martin Möckel, MD; Christoph Bickel, MD; Dirk Peetz, MD; Karl Lackner, MD; Stephan Baldus, MD; Thomas Münzel, MD; Stefan Blankenberg, MD, (2011). Serial Changes in Highly Sensitive Troponin I Assay and Early Diagnosis of Myocardial Infarction. The Journal of American Medical Association, doi: 10.1001/jama.2011.1896

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