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Abstract
Background: Acute coronary syndromes or ACS is an emergency that should be diagnosed and managed as soon as possible, contributing to reducing mortality rate and complications. Unfortunately, there have been few studies of the combination of IMA and hs-TroponinT in ACS diagnosis. This study determine serum IMA and hs-TnT levels in the ACS patients. To determine / and the sensitivity and the specificity when combining serum of the combined use of IMA and hs-TnT in the diagnosis of ACS.
Methods: 253 patients admitted to Hue Central Hospital were divided into 2 groups. The study group included 130 patients diagnosed with ACS according to the Fourth Universal Definition of Myocardial Infarction Consensus 2018. Meanwhile, 123 non - ACS patients belonged to the control group. A cross - sectional study was conducted.
Results: The concentrations of hs-TnT and IMA in the study group were higher than those in the control group. The concentration of hs-TnT in the ACS group was significantly higher than those in the control group at both time points (median 0.23ng/ mL > 0.006ng/mL and 1.26ng/mL > 0.006ng/mL) ( p < 0.001). Mean serum IMA levels of patients in the ACS group was higher than, 79.26 ± 114.15 IU/mL (median 46.26 IU/ mL) versus 24.23 ± 27.14 IU/mL (median 17. 45 IU/mL); (p < 0.001). (Đã sửa theo ý kiến phản biện). The diagnostic cut - off point for ACS of hs-TnT1 was 0.0165 ng/mL with sensitivity 84.3%, specificity 87.8%, area under the ROC curve 0.90 with p < 0.001, 95% CI : 0.86 - 0.94. The diagnostic cut - off point for ACS of hs-TnT2 was 0.0165 ng/mL with sensitivity 89%, specificity 88.6%, area under the ROC curve 0.93 with p < 0.001, 95% CI: 0 .89 - 0.97. (hs-TnT2 - hs-TnT1) cut - off > 0.008 ng/mL was significant in the diagnosis of ACS, sensitivity 53.08%, specificity 98.37%, area under the ROC curve: 0.621 (95% CI: 0.56 - 0.68), p < 0.05. The combined use of IMA and hs-TnT1 in the diagnosis of ACS, the specificity increased to 98.37% and the positive predictive value enhanced 97.87%. Meanwhile, the specificity and positive predictive value of IMA and hs-TnT2 in the diagnosis of ACS were almost unchanged. When IMA is combined with (hs-TnT2 - hs-TnT1), the sensitivity and specificity in the diagnosis of ACS are 46.15% and 100.00%, respectively. With an hs-TnT cut - off of 0.014ng/mL, the sensitivity and specificity of hs-TnT1 in the diagnosis of ACS were 84.62% and 85.37% and hs-TnT2 respectively 88.46% and 86.99%. When IMA was combined with hs-TnT at the cut - off point of 0.014 ng/ml, the sensitivity and specificity of IMA and hs-TnT1 in the diagnosis of ACS were 70.77% and 98.37% and hs-TnT2 are 73.85% and 98.37%, respectively.
Conclusion: The combined use of IMA and hs-TroponinT has a higher diagnostic value of ACS than hs-Troponin T or IMA alone.
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| Published | 20-08-2023 | |
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| Issue | No. 89 (2023) | |
| Section | Original article | |
| DOI | 10.38103/jcmhch.89.11 | |
| Keywords | hs-Troponin T, IMA, Hội chứng vành cấp. Acute coronary syndrome. |
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