高感度心臓トロポニン検査の急性心筋梗塞早期診断の優秀性

高感度心臓トロポニン検査 (Abbott–Architect Troponin I、 Roche High-Sensitive Troponin T、 Roche Troponin I、Siemens Troponin I Ultra)による心筋梗塞早期診断はパフォーマンス優秀

Early Diagnosis of Myocardial Infarction with Sensitive Cardiac Troponin Assays
N Engl. J Med. Vol. 361:(9) 858-867



AUC-RCにて定量化した、診断正確性検討は、四つの心臓トロポニンアッセイは標準アッセイより有意に高い


急性心筋梗塞示唆する症状のある718名の連続患者で、最終的に123名の心筋梗塞に関して検討

・　Sensitivity of 90.7% with sensitive troponin I, 72.7% with standard troponin T, and 61.3% with myoglobin
・　Specificity of 90.2% with sensitive troponin I, 94.1% with standard troponin T, and 86.9% with myoglobin
・　Positive predictive value of 76.7% with sensitive troponin I, 81.4% with standard troponin T, and 60.5% with myoglobin
・　Negative predictive value of 96.4% with sensitive troponin I, 90.7% with standard troponin T, and 87.3% with myoglobin

Diagnostic accuracy of a single measure at presentation was highest for the sensitive assays

＊　96% with Abbott-Architect Troponin I (95% confidence interval 0.94 to 0.98)
＊　96% with Roche's High-Sensitive Troponin T (95% CI 94% to 98%)
＊　95% with Roche's Troponin I (95% CI 92% to 97%)
＊　96% with Siemens' Troponin I Ultra (95% CI 94% to 98%)
＊　90% with conventional troponin T (95% CI 64% to 88%)