Abstract | BACKGROUND: METHODS: We enrolled 256 acute coronary syndrome patients at four medical centers. Blood specimens were collected at presentation and then 6-24 h later. The dichotomous decision limit and performance characteristics of the ACB Test for predicting troponin-positive or -negative status 6 h-24 h later were determined using ROC curve analysis. Results for 32 patients could not be used because the time of onset of ischemia appeared to have been >3 h before presentation or was uncertain. The reference interval was determined by parametric analysis to estimate the upper 95th percentile of a reference population (n = 109) of ostensibly healthy individuals. RESULTS: Increased cTnI was found in 35 of 224 patients. The ROC curve area for the ACB Test was 0.78 [95% confidence interval (CI), 0.70-0.86]. At the optimum decision point of 75 units/mL, the sensitivity and specificity of the ACB Test were 83% (95% CI, 66-93%) and 69% (95% CI, 62-76%). The negative predictive value was 96% (95% CI, 91-98%), and the positive predictive value was 33% (95% CI, 24-44%). The within-run CV of the ACB Test was 7.3%. Results for the reference population were normally distributed; the one-sided parametric 95th percentile was 80.2 units/mL. CONCLUSIONS: This exploratory study suggests that the ACB Test has high negative predictive value and sensitivity in the presentation sample for predicting troponin-negative or -positive results 6-24 h later.
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Authors | R H Christenson, S H Duh, W R Sanhai, A H Wu, V Holtman, P Painter, E Branham, F S Apple, M Murakami, D L Morris |
Journal | Clinical chemistry
(Clin Chem)
Vol. 47
Issue 3
Pg. 464-70
(Mar 2001)
ISSN: 0009-9147 [Print] England |
PMID | 11238298
(Publication Type: Evaluation Study, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
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Chemical References |
- Albumins
- Troponin I
- Cobalt
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Topics |
- Acute Disease
- Adult
- Aged
- Aged, 80 and over
- Albumins
(metabolism)
- Cobalt
(metabolism)
- Coronary Disease
(blood, diagnosis)
- Female
- Humans
- Male
- Middle Aged
- Protein Binding
- Reproducibility of Results
- Sensitivity and Specificity
- Syndrome
- Troponin I
(analysis)
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