Aim. Study the immediate clinical significance of determination of highly sensitive troponin (high sensitive cardiac troponin - hscTn) in the early diagnosis of acute myocardial infarction (AMI). Material and methods. The analysis of nosological diagnosis in 92 patients with acute coronary syndrome (ACS), urgently hospitalized in the coronary care unit of the Nizhny Novgorod regional hospital. N.A. Semashko. The time from the moment of development of pain syndrome, hospitalization in a hospital ranged from 40 minutes to 4 hours, averaging 2.5 ± 0.32 hours. During hospitalization of patients in the complex diagnosis of AMI in addition to General clinical examination, ECG was determined by the content hscTn and troponin I. All patients in the hospital was performed selective coronary angiography (SCG). Evaluated the sensitivity, specificity and diagnostic accuracy hscTn in comparison with troponin I. Analysis results were represented as a percentage and using a software package "STATISTICA 10.0" (StatSoft, Inc., USA). Results. AMI is diagnosed in 74% of cases (n=68), and the rest 26% (n=24) unstable (progressive) angina (NS). Transmural myocardial infarction or Q-wave myocardial infarction detected in 54% (n=37) of patients. Intramural myocardial infarction or non Q-wave myocardial infarction - in 46% (n=31). AMI re-seen in 27% (n=18). Importance of the study of both cardiac troponin in the early diagnosis of AMI showed the following. Sensitivity hscTn reached 98%, while troponin I - 88%. Specificity hscTn was 79%, and troponin I, only 66%. Overall diagnostic accuracy hscTn was 92%, troponin I less - 83%). Conclusion. The results of the study indicate a predominant clinical significance hscTn in comparison with troponin I in early diagnosis of AMI in the parameters of sensitivity, specificity and diagnostic accuracy.
Early diagnosis of acute myocardial infarction in the elderly using more sensitive cardiac troponin assays