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Cardiac troponin testing and myocardial infarction
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Correspondence
Beuy Joob, PhD Sanitation 1 Medical Academic Center, Bangkok E-mail address: [email protected]
Cardiac troponin testing and myocardial infarction To the Editor, We would like to discuss the recent article on “Cardiac troponin testing and myocardial infarction” [1]. Maag et al concluded that “applying information on the PPV of troponin for type I MI based on the clinical history could improve troponin utilization and clinical decision making” [1]. In fact, any diagnostic test will be useless if the user does not consider the clinical history. Focusing on the cardiac marker, including cardiac troponin, the “time course” is an important determinant of diagnostic property. At different periods after first onset, the diagnostic value of the test is different. Furthermore, the diagnostic property of the cardiac troponin is also related to the specific laboratory method of each commercial assay. For example, a recent publication by TerAvest et al showed that “AQT90-flex POCT cTnT assay is not yet sensitive and reliable” for use in the emergency department [2].
Viroj Wiwanitkit, MD Hainan Medical University, China Faculty of Medicine, University of Nis, Serbia Joseph Ayobabalola University, Nigeria Dr DY Patil Medical University, India http://dx.doi.org/10.1016/j.ajem.2015.03.003 References [1] Maag R, Sun S, Hannon M, Davies R, Alagona P, Foy A. Positive predictive value of an elevated cardiac troponin for type I myocardial infarction in ED patients based on the chief complaint. Am J Emerg Med 2015 [pii: S0735-6757(15)00005-4]. [2] TerAvest E, Visser A, Reitsma B, Breedveld R, Wolthuis A. Point-of-care troponin T is inferior to high-sensitivity troponin T for ruling out acute myocardial infarction in the emergency department. Eur J Emerg Med 2014 [Epub ahead of print].
Correspondence
Beuy Joob, PhD Sanitation 1 Medical Academic Center, Bangkok E-mail address: [email protected]
Cardiac troponin testing and myocardial infarction To the Editor, We would like to discuss the recent article on “Cardiac troponin testing and myocardial infarction” [1]. Maag et al concluded that “applying information on the PPV of troponin for type I MI based on the clinical history could improve troponin utilization and clinical decision making” [1]. In fact, any diagnostic test will be useless if the user does not consider the clinical history. Focusing on the cardiac marker, including cardiac troponin, the “time course” is an important determinant of diagnostic property. At different periods after first onset, the diagnostic value of the test is different. Furthermore, the diagnostic property of the cardiac troponin is also related to the specific laboratory method of each commercial assay. For example, a recent publication by TerAvest et al showed that “AQT90-flex POCT cTnT assay is not yet sensitive and reliable” for use in the emergency department [2].
Viroj Wiwanitkit, MD Hainan Medical University, China Faculty of Medicine, University of Nis, Serbia Joseph Ayobabalola University, Nigeria Dr DY Patil Medical University, India http://dx.doi.org/10.1016/j.ajem.2015.03.003 References [1] Maag R, Sun S, Hannon M, Davies R, Alagona P, Foy A. Positive predictive value of an elevated cardiac troponin for type I myocardial infarction in ED patients based on the chief complaint. Am J Emerg Med 2015 [pii: S0735-6757(15)00005-4]. [2] TerAvest E, Visser A, Reitsma B, Breedveld R, Wolthuis A. Point-of-care troponin T is inferior to high-sensitivity troponin T for ruling out acute myocardial infarction in the emergency department. Eur J Emerg Med 2014 [Epub ahead of print].