Validation of a high sensitive troponin 99th percentile obtained in a general hospital.

High sensitivity cardiac Troponin T (hs-cTnT) dosage is recommended for myocardial infarction diagnosis, by applying the 99th percentile obtained from a healthy population by the manufacturer. The objective is to validate the 99th percentile in a population from our hospital (99L), compared with the...

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Autores principales: Martínez, María Laura, Bertazzo, Brunella Bianca, Gonzalez Grima, Juan, Figueroa Córdoba, Ana Virginia, Konicoff, Mailen, Martina, Luciana, Rossa, Victoria, Amuchastegui, Marcos, Brenna, Eduardo Javier, Salomone, Oscar, Ferrero Guadagnoli, Adolfo, Contreras, Alejandro Ernesto
Formato: Artículo revista
Lenguaje:Español
Publicado: Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2020
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Acceso en línea:https://revistas.unc.edu.ar/index.php/med/article/view/27473
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id I10-R327-article-27473
record_format ojs
institution Universidad Nacional de Córdoba
institution_str I-10
repository_str R-327
container_title_str Revista de la Facultad de Ciencias Médicas de Córdoba
language Español
format Artículo revista
topic Troponin T
myocardial infarction
validation studies
Troponina T
infarto de miocardio
estudios de validación
Troponina T
infarto do miocárdio
estudos de validação
spellingShingle Troponin T
myocardial infarction
validation studies
Troponina T
infarto de miocardio
estudios de validación
Troponina T
infarto do miocárdio
estudos de validação
Martínez, María Laura
Bertazzo, Brunella Bianca
Gonzalez Grima, Juan
Figueroa Córdoba, Ana Virginia
Konicoff, Mailen
Martina, Luciana
Rossa, Victoria
Amuchastegui, Marcos
Brenna, Eduardo Javier
Salomone, Oscar
Ferrero Guadagnoli, Adolfo
Contreras, Alejandro Ernesto
Validation of a high sensitive troponin 99th percentile obtained in a general hospital.
topic_facet Troponin T
myocardial infarction
validation studies
Troponina T
infarto de miocardio
estudios de validación
Troponina T
infarto do miocárdio
estudos de validação
author Martínez, María Laura
Bertazzo, Brunella Bianca
Gonzalez Grima, Juan
Figueroa Córdoba, Ana Virginia
Konicoff, Mailen
Martina, Luciana
Rossa, Victoria
Amuchastegui, Marcos
Brenna, Eduardo Javier
Salomone, Oscar
Ferrero Guadagnoli, Adolfo
Contreras, Alejandro Ernesto
author_facet Martínez, María Laura
Bertazzo, Brunella Bianca
Gonzalez Grima, Juan
Figueroa Córdoba, Ana Virginia
Konicoff, Mailen
Martina, Luciana
Rossa, Victoria
Amuchastegui, Marcos
Brenna, Eduardo Javier
Salomone, Oscar
Ferrero Guadagnoli, Adolfo
Contreras, Alejandro Ernesto
author_sort Martínez, María Laura
title Validation of a high sensitive troponin 99th percentile obtained in a general hospital.
title_short Validation of a high sensitive troponin 99th percentile obtained in a general hospital.
title_full Validation of a high sensitive troponin 99th percentile obtained in a general hospital.
title_fullStr Validation of a high sensitive troponin 99th percentile obtained in a general hospital.
title_full_unstemmed Validation of a high sensitive troponin 99th percentile obtained in a general hospital.
title_sort validation of a high sensitive troponin 99th percentile obtained in a general hospital.
description High sensitivity cardiac Troponin T (hs-cTnT) dosage is recommended for myocardial infarction diagnosis, by applying the 99th percentile obtained from a healthy population by the manufacturer. The objective is to validate the 99th percentile in a population from our hospital (99L), compared with the manufacturer´s 99th percentile (99F) by using coronary angiography as gold standard.  Materials and method: Retrospective analysis of every hs-cTnT (Roche) obtained from patients admitted with acute coronary syndromes (ACS) who underwent coronary angiography between 2015 and 2018. Results: 415 patients were included for analysis (118 females, 64.2 yo). 99F sensitivity (Sn) for significant coronary artery disease (stenosis >70%) was 83.6%, with a specificity (Sp) of 44.5%. Positive predictive value (PPV) and negative predictive value (NPV) were 77% and 55% respectively. 99L Sn was 69.7% and Sp 58.6%. PPV was 79% and NPV 46%. ROC curve was 0.641 for 99F and 0.641 for 99L. Conclusion: Given the importance of hs-cTnT in ACS diagnosis, the 99F should be the preferred upper reference limit since the sensitivity is better, although lower compared to prior studies.
publisher Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
publishDate 2020
url https://revistas.unc.edu.ar/index.php/med/article/view/27473
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spelling I10-R327-article-274732024-08-27T18:27:30Z Validation of a high sensitive troponin 99th percentile obtained in a general hospital. Validación de percentil 99 de troponina ultrasensible obtenido en la población de un hospital general Validação do percentilo 99 de troponina ultrasensível obtido em um hôspital geral. Martínez, María Laura Bertazzo, Brunella Bianca Gonzalez Grima, Juan Figueroa Córdoba, Ana Virginia Konicoff, Mailen Martina, Luciana Rossa, Victoria Amuchastegui, Marcos Brenna, Eduardo Javier Salomone, Oscar Ferrero Guadagnoli, Adolfo Contreras, Alejandro Ernesto Troponin T myocardial infarction validation studies Troponina T infarto de miocardio estudios de validación Troponina T infarto do miocárdio estudos de validação High sensitivity cardiac Troponin T (hs-cTnT) dosage is recommended for myocardial infarction diagnosis, by applying the 99th percentile obtained from a healthy population by the manufacturer. The objective is to validate the 99th percentile in a population from our hospital (99L), compared with the manufacturer´s 99th percentile (99F) by using coronary angiography as gold standard.  Materials and method: Retrospective analysis of every hs-cTnT (Roche) obtained from patients admitted with acute coronary syndromes (ACS) who underwent coronary angiography between 2015 and 2018. Results: 415 patients were included for analysis (118 females, 64.2 yo). 99F sensitivity (Sn) for significant coronary artery disease (stenosis >70%) was 83.6%, with a specificity (Sp) of 44.5%. Positive predictive value (PPV) and negative predictive value (NPV) were 77% and 55% respectively. 99L Sn was 69.7% and Sp 58.6%. PPV was 79% and NPV 46%. ROC curve was 0.641 for 99F and 0.641 for 99L. Conclusion: Given the importance of hs-cTnT in ACS diagnosis, the 99F should be the preferred upper reference limit since the sensitivity is better, although lower compared to prior studies. El dosaje de troponina ultrasensible (TnT US) se recomienda para el diagnóstico de infarto de miocardio, para lo cual se utiliza como punto de corte el percentil 99 (p99) obtenido por el fabricante (99F) en población sana. El objetivo de este estudio es validar el p99 obtenido en la población de este hospital (99L) frente al 99F, utilizando la cinecoronariografía (CCG) como gold standard. Materiales y métodos: análisis retrospectivo de TnT US Roche realizada a todos los pacientes que ingresaron por SCA (síndrome coronario agudo) a los que se les realizó CCG entre 2015 y 2018. Se utilizó para el procesamiento estadístico el programa IBM SPSS Statistics 24 y tablas de sensibilidad y especificidad para métodos diagnósticos (EviCardio). Resultados: se incluyeron 415 pacientes, 118 de sexo femenino, con edad de 64,2 ± 12,5 años. La sensibilidad del 99F para diagnóstico de enfermedad coronaria severa (obstrucción ≥ 70%) fue de 83,6% y la especificidad, 44,5%. El valor predictivo positivo (VPP) fue de 77% y el negativo (VPN) 55%. La sensibilidad del 99L se calculó en 69,7% y la especificidad, 58,6%. El VPP fue 79% y el VPN 46%. El ABC (área bajo la curva) resultó ser 0,641 para el 99Fy 0,641 para el 99L. Conclusiones: Debido a la importancia de la sensibilidad en el uso de la TnT US como herramienta diagnóstica ante la sospecha de SCA, debemos seguir utilizando el 99F ya que mostró mayor sensibilidad que 99L (aunque menor a la reportada en estudios previos). O dosagem da troponina ultrasensivel (TnT US) é recomendado para o diagnóstico do infarto do miocárdio, para isso o ponto de corte usado é o percentilo 99 (p99), obtido pelo fabricante (99F) en população saudável. O objetivo de esse estudo é validar o p99 na população desse hospital (99L) frente ao 99F, utilizando a cinecoronariografía (CCG) como gold standard. Materiais e métodos: se realizou um análise retrospectivo de  TnT US Roche realizada a todos os pacientes que ingresaram pôr SCA (síndrome coronariano agudo) a quem tenham realizado CCG entre 2015 e 2018. Se utilizou para o processamento estadístico o programa IBM SPSS Statistics 24 e tabelas de sensibilidade y especificidade para métodos diagnósticos (EviCardio). Resultados: se incluyeram 415 pacientes, 118 de sexo femenino, en idade de 64,2 ± 12,5 anos. A sensibilidade do 99F para dianóstico de enfermedade coronariana severa (obstruçãon ≥ 70%) foi de 83,6% e a especificidade, 44,5%. O valor preditivo positivo  (VPP) foi de 77% e o negativo (VPN) 55%. A sensibilidade do 99L, foi calculada em 69,7% e a especificidade, 58,6%. O VPP foi 79% e o VPN 46%. O ASC (área sob a curva) resultou 0,641 para o 99F e 0,641 para o 99L. Concluções: Pela importância da sensibilidade no uso da TnT US como ferramenta diagnóstica ante o suspeito de SCA, resulta preciso continuar utilizando o 99F visto que tem demostrado ser mais sensível. (Ainda quando é menor à reportada em estudos anteriores). Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2020-12-01 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf text/html https://revistas.unc.edu.ar/index.php/med/article/view/27473 10.31053/1853.0605.v77.n4.27473 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 77 No. 4 (2020); 281-284 Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 77 Núm. 4 (2020); 281-284 Revista da Faculdade de Ciências Médicas de Córdoba; v. 77 n. 4 (2020); 281-284 1853-0605 0014-6722 10.31053/1853.0605.v77.n4 spa https://revistas.unc.edu.ar/index.php/med/article/view/27473/32415 https://revistas.unc.edu.ar/index.php/med/article/view/27473/32474 Derechos de autor 2020 Universidad Nacional de Córdoba https://creativecommons.org/licenses/by-nc/4.0