Sequential Assessment of Troponin in the Diagnosis of Myocardial Infarction

Brandon Edwards; Irsha Washington; Lester G. Pretlow; Gregory Passmore; James Dias; Scott Wise

doi:10.29074/ascls.26.2.95

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Brandon Edwards, MHS
1. Department of Medical Laboratory, Imaging and Radiological Sciences, Georgia Regents University, Augusta, GA
Irsha Washington, MHS
1. Department of Medical Laboratory, Imaging and Radiological Sciences, Georgia Regents University, Augusta, GA
Lester G. Pretlow, Ph.D., C(ASCP)^CM, NRCC(CC)⇑
1. Department of Medical Laboratory, Imaging and Radiological Sciences, Georgia Regents University, Augusta, GA
Gregory Passmore, PhD
1. Department of Medical Laboratory, Imaging and Radiological Sciences, Georgia Regents University, Augusta, GA
James Dias, PhD
1. Department of Medical Laboratory, Imaging and Radiological Sciences, Georgia Regents University, Augusta, GA
Scott Wise, MHS
1. Department of Medical Laboratory, Imaging and Radiological Sciences, Georgia Regents University, Augusta, GA

Address for Correspondence: Lester G. Pretlow, Ph.D., C(ASCP)^CM, NRCC(CC), Chair and Associate Professor, Department of Medical Laboratory, Imaging and Radiological Sciences, Georgia Regents University, 987 St. Sebastian Way, EC-3338, Augusta, GA 30912, 706-721-7629, lpretlow{at}georgiahealth.edu

Abstract

According to the American Heart Association, cardiovascular disease accounts for more than one third of all deaths in the United States. ¹ The purpose of this retrospective case-control study was to determine which sample taken in a sequential draw was most important in diagnosing an acute myocardial infarction (AMI). One-hundred subjects were selected from a convenience sample. The “risk” of AMI diagnosis was modeled using binary multiple logistic regression. Overall, 78% (39 out of 50 cases) were diagnosed with an AMI at T_initial. Clearly, the initial cTnI assay is the most critical of the four sequential time points for the accurate assessment of the presence or absence of an AMI. Most importantly, sequential troponin testing increased the ability to diagnose AMI by 10-fold.

ABBREVIATIONS: ECG - electrocardio-gram, CK - creatine kinase, AMI – acute myocardial infarction, cTnI - cardiac troponin I, CSRA - Central Savannah River Area, STEMI - ST-elevation myocardial infarction