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Revista Colombiana de Cardiología
Print version ISSN 0120-5633
Abstract
MARIN-OROZCO, Isabel C.; ZAPATA-DUQUE, Juan G. and DIAZ-BETANCUR, James S.. High sensitivity troponin I to early rule out for acute myocardial infarction. Rev. Colomb. Cardiol. [online]. 2022, vol.29, n.3, pp.277-285. Epub Sep 01, 2022. ISSN 0120-5633. https://doi.org/10.24875/rccar.m22000157.
Introduction:
The greatest utility of high-sensitivity troponins (Tn-hs) is to rule out acute myocardial infarction (AMI) early. The algorithm recommended by the Colombian practice guideline clinical (CPG) of Healths Ministry to rule out AMI is supported by low-quality evidence and has not been validated in the Colombian population. This research aims to evaluate the ability of this algorithm using high sensitivity troponin I (TnI-hs) to rule out AMI without ST segment elevation (STEMI).
Methods:
Patients with suspected acute coronary syndrome (ACS) treated in an emergency department of a highly complex center were analyzed. The primary outcome was the diagnosis of STEMI type 1 and type 4b. The operativing characteristics for the algorithm cut-off points were determined for the primary outcome, hospital readmission death at and 30 days.
Results:
2282 patients were included in whom the primary outcome occurred in 389. The Colombian CPG algorithm had S of 90.9% (95% CI 74-100) and NPV of 99% (95% CI 99-100) using the 99th percentile (p99) not discriminated by sex, but both S and NPV improved 100% when p99 was used by sex.
Conclusion:
The algorithm recommended by the Colombian CPG using TnI-hs and with the p99 adjusted for sex has an excellent capacity to rule out early and safely the diagnosis of STEMI.
Keywords : Troponin I; Acute myocardial infarction; Diagnostic test.