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OP-197 Comparisons of High Sensitive and Conventional Troponin Assays in the Disagnosis of Acute Myocardial İnfarction in Emergency Department
MARCH 26e29, 2015
O R A L A B S T R A C T S
a number of hemodialyses patients with high CAC scores can be require coronary revascularisation within a few years. Among dialysis patients undergoing coronary revascularization,in-hospital mortality was seemed to be higher after CABG,however; long-term survival after CABG was superior then PCI. In PCI group. High CAC scores, diabetes mellitus, duration of dialyses,and a high blood calcium and phosphorus level were independent risk factors for early and repeat revascularisation.
- OP-197 Comparisons of High Sensitive and Conventional Troponin Assays in the Disagnosis of Acute Myocardial _ Infarction in Emergency Department. Nilgun Isiksacan1, Ismail Biyik2, Hüseyin Karakurt3, Begum Ozalp3, Omer Faruk Baycan3, Mehmet Rıfat Yıldırım3, Abdurrahman Yilmaz4, Ibrahim Faruk Akturk3, Mehmet Erturk3. 1Department of Biochemistry, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey; 2Department of Cardiology, Usak State Hospital Heart Center, Usak, Turkey; 3 Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey; 4Department of Emergency Medicine, Usak State Hospital, Usak, Turkey. Background: The advances in the biochemical research for the discovering an ideal biomarker for the diagnosis of acute myocardial infarction have led to discovery of cardiac troponins as a gold standard marker of myocardial injury. By courtesy of advances in the immunoassay techniques, the 99th percentile cutoff value of cardiac troponins required for the diagnosis of acute myocardial infarction decreased, with the latest available ultrasensitive cardiac troponin assays capable of measuring level as low as 0.005 ng/ml. Troponins have both diagnostic as well as prognostic significance in myocardial necrosis, but the results must be interpreted nin the context of clinical history, ECG findings, and cardiac imaging techniques like echocardiography to establish the correct diagnosis. Purpose: Cardiac troponins are also elevated in other cardiac conditions such as cardiomyopathy, heart failure, renal failure, pulmonary embolism, etc. the serial monitoring of the cardiac troponins along with the absolute value would help to differentiate myocardial infarction from these many other conditions. In this study, we aimed to investigate the positive predictive value of four different cardiac troponin assays in the diagnosis of acute myocardial infarction. Methods: 527 patients having symptoms of acute coronary syndrome were included in the study. Coronary angiographically confirmed acute myocardial infarction has been revealed in 163 patients. The positive predictive values (PPV) and negative predictive values (NPV) of four different troponin assays in the correct diagnosis of acute myocardial infarction were compared. Results: High sensitive troponin I (Time resolved fluorescence method, Radiometer AQT 90 flex, Denmark) has been found a sensitivity of 56,82 %, a specificity of 71,34%, PPV 45,5%, NPV 79,7% and (positive likelihood ratio) LRþ 1,98. Troponin I Triage ( Fluorescence Immunoassay, Biosite, USA) has a sensitivity of 47,13%, a specificity 76,12%, PPV 46,5%, NPV 76,6% and LRþ 1,97. Troponin I (Toyo, chromatographic immunoassay, Turkey) has been found a sensitivity 29,4 %, a specificity of 88,62 %, PPV 51,5 %, NPV 75,4%, LRþ 2,58.
Figure. Comparisons of sensitivity and specificity of different troponin assays in the diagnosis of acute myocardial infarction. High sensitive troponin T R (e 411 analyzer, Roche Method, Chemiluminescence, USA) has been found a sensitivity of 60,49%, a specificity of 67,42%, PPV 45,8%, NPV 78,9%, LRþ 1,86. Conclusions: In the present study, there was no statistically significant difference between four different troponin assays in comparisons of PPV and NPV in the correct diagnosis of acute myocardial infarction, but low sensitivity of Triage and Toyo (Turklab) assays should be considered.
Importance of Non-invasive Electrocardiologic Parameters in Clinical Practice: Where are we standing in 2015? Sunday, March 29, 2015 12:00 PM w 13:30 PM, Hall 8 (Abstract nos. OP-198 w OP-204) - OP-198 Evaluate the Heart Rate Recovery Index in Patients with Heavy Cigarette Smoking. Mehmet Erat, Mehmet Dogan, Hamza Sunman, Engin Algül, Mehmet Ali Felekoglu, Kadriye Gayretli Yayla, Lale Dinç Asarcıklı, Tolga Han Efe, Murat Bilgin, Tolga Çimen, Ahmet Akyel, Ekrem Yeter. Department of Cardiology, Dıs¸kapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey. Objective: Cigarette smoking increases the risk of cardiovascular events related with several mechanisms. The most suggested
S90 The American Journal of Cardiologyâ MARCH 26e29, 2015 11th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Oral
O R A L A B S T R A C T S
a number of hemodialyses patients with high CAC scores can be require coronary revascularisation within a few years. Among dialysis patients undergoing coronary revascularization,in-hospital mortality was seemed to be higher after CABG,however; long-term survival after CABG was superior then PCI. In PCI group. High CAC scores, diabetes mellitus, duration of dialyses,and a high blood calcium and phosphorus level were independent risk factors for early and repeat revascularisation.
- OP-197 Comparisons of High Sensitive and Conventional Troponin Assays in the Disagnosis of Acute Myocardial _ Infarction in Emergency Department. Nilgun Isiksacan1, Ismail Biyik2, Hüseyin Karakurt3, Begum Ozalp3, Omer Faruk Baycan3, Mehmet Rıfat Yıldırım3, Abdurrahman Yilmaz4, Ibrahim Faruk Akturk3, Mehmet Erturk3. 1Department of Biochemistry, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey; 2Department of Cardiology, Usak State Hospital Heart Center, Usak, Turkey; 3 Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey; 4Department of Emergency Medicine, Usak State Hospital, Usak, Turkey. Background: The advances in the biochemical research for the discovering an ideal biomarker for the diagnosis of acute myocardial infarction have led to discovery of cardiac troponins as a gold standard marker of myocardial injury. By courtesy of advances in the immunoassay techniques, the 99th percentile cutoff value of cardiac troponins required for the diagnosis of acute myocardial infarction decreased, with the latest available ultrasensitive cardiac troponin assays capable of measuring level as low as 0.005 ng/ml. Troponins have both diagnostic as well as prognostic significance in myocardial necrosis, but the results must be interpreted nin the context of clinical history, ECG findings, and cardiac imaging techniques like echocardiography to establish the correct diagnosis. Purpose: Cardiac troponins are also elevated in other cardiac conditions such as cardiomyopathy, heart failure, renal failure, pulmonary embolism, etc. the serial monitoring of the cardiac troponins along with the absolute value would help to differentiate myocardial infarction from these many other conditions. In this study, we aimed to investigate the positive predictive value of four different cardiac troponin assays in the diagnosis of acute myocardial infarction. Methods: 527 patients having symptoms of acute coronary syndrome were included in the study. Coronary angiographically confirmed acute myocardial infarction has been revealed in 163 patients. The positive predictive values (PPV) and negative predictive values (NPV) of four different troponin assays in the correct diagnosis of acute myocardial infarction were compared. Results: High sensitive troponin I (Time resolved fluorescence method, Radiometer AQT 90 flex, Denmark) has been found a sensitivity of 56,82 %, a specificity of 71,34%, PPV 45,5%, NPV 79,7% and (positive likelihood ratio) LRþ 1,98. Troponin I Triage ( Fluorescence Immunoassay, Biosite, USA) has a sensitivity of 47,13%, a specificity 76,12%, PPV 46,5%, NPV 76,6% and LRþ 1,97. Troponin I (Toyo, chromatographic immunoassay, Turkey) has been found a sensitivity 29,4 %, a specificity of 88,62 %, PPV 51,5 %, NPV 75,4%, LRþ 2,58.
Figure. Comparisons of sensitivity and specificity of different troponin assays in the diagnosis of acute myocardial infarction. High sensitive troponin T R (e 411 analyzer, Roche Method, Chemiluminescence, USA) has been found a sensitivity of 60,49%, a specificity of 67,42%, PPV 45,8%, NPV 78,9%, LRþ 1,86. Conclusions: In the present study, there was no statistically significant difference between four different troponin assays in comparisons of PPV and NPV in the correct diagnosis of acute myocardial infarction, but low sensitivity of Triage and Toyo (Turklab) assays should be considered.
Importance of Non-invasive Electrocardiologic Parameters in Clinical Practice: Where are we standing in 2015? Sunday, March 29, 2015 12:00 PM w 13:30 PM, Hall 8 (Abstract nos. OP-198 w OP-204) - OP-198 Evaluate the Heart Rate Recovery Index in Patients with Heavy Cigarette Smoking. Mehmet Erat, Mehmet Dogan, Hamza Sunman, Engin Algül, Mehmet Ali Felekoglu, Kadriye Gayretli Yayla, Lale Dinç Asarcıklı, Tolga Han Efe, Murat Bilgin, Tolga Çimen, Ahmet Akyel, Ekrem Yeter. Department of Cardiology, Dıs¸kapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey. Objective: Cigarette smoking increases the risk of cardiovascular events related with several mechanisms. The most suggested
S90 The American Journal of Cardiologyâ MARCH 26e29, 2015 11th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Oral