Advantage of Using of High-Sensitivity Troponin I Compared to Conventional Troponin I in Shortening Time to Rule out/in Acute Coronary Syndrome in Chest Pain Patients Presenting to the Emergency Department
<i>Background and Objectives</i>: We aimed to compare the time to diagnosis for acute coronary syndromes using high-sensitivity troponin I (hsTnI) and conventional troponin I (TnI) in patients presenting to the emergency department (ED) with chest pain. <i>Materials and Methods<...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-10-01
|
| Series: | Medicina |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1648-9144/58/10/1391 |
| _version_ | 1797471643183874048 |
|---|---|
| author | Ziwei Lin Patrizia Cardelli Rossella Marino Swee Han Lim Salvatore Di Somma |
| author_facet | Ziwei Lin Patrizia Cardelli Rossella Marino Swee Han Lim Salvatore Di Somma |
| author_sort | Ziwei Lin |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: We aimed to compare the time to diagnosis for acute coronary syndromes using high-sensitivity troponin I (hsTnI) and conventional troponin I (TnI) in patients presenting to the emergency department (ED) with chest pain. <i>Materials and Methods</i>: This was an observational prospective study involving patients presenting to the ED of Sant’Andrea Hospital University la Sapienza in Rome (Italy) with chest pain from January to December 2014. Serum troponin was drawn at presentation, and at 3, 6, 9, and/or 12 h if clinically indicated. Depending on date of recruitment, patients had either hsTnI (Abbott Laboratories) or TnI (Abbott Laboratories) performed. The primary endpoint was the time to diagnosis at index visit. <i>Results</i>: A total of 1059 patients were recruited, (673 [63.6%] male, median age 60 years [interquartile range 49–73 years]), out of whom 898 (84.8%) patients were evaluated with hsTnI and 161 (15.2%) with TnI. A total of 393 (37.1%) patients had the diagnosis of acute coronary syndrome in ED. The median time to diagnosis for those evaluated with TnI was 400 min, IQR 120–720 min, while the use of hsTnI led to a significantly shorter time to diagnosis (median 200 min, IQR 100–200 min, <i>p</i> < 0.001). <i>Conclusions</i>: This study confirms that in patients presenting to the emergency department with chest pain, the use of hsTnI is associated with a reduced time to ruling in/out ACS, and, consequently, hsTnI should be routinely used over TnI for more rapid identification of ACS with benefits for patients and related costs. |
| first_indexed | 2024-03-09T19:51:06Z |
| format | Article |
| id | doaj.art-4dfd92e3d6de4700839a2c458d17a198 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-09T19:51:06Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-4dfd92e3d6de4700839a2c458d17a1982023-11-24T01:10:19ZengMDPI AGMedicina1010-660X1648-91442022-10-015810139110.3390/medicina58101391Advantage of Using of High-Sensitivity Troponin I Compared to Conventional Troponin I in Shortening Time to Rule out/in Acute Coronary Syndrome in Chest Pain Patients Presenting to the Emergency DepartmentZiwei Lin0Patrizia Cardelli1Rossella Marino2Swee Han Lim3Salvatore Di Somma4Emergency Medicine Department, National University Hospital, National University Health System, Singapore 119074, SingaporeDepartment of Medical-Surgery Sciences and Translational Medicine, University Sapienza of Rome, 00189 Roma, ItalyDepartment of Medical-Surgery Sciences and Translational Medicine, University Sapienza of Rome, 00189 Roma, ItalyDepartment of Emergency Medicine, Singapore General Hospital, Singapore 169608, SingaporeDepartment of Medical-Surgery Sciences and Translational Medicine, University Sapienza of Rome, 00189 Roma, Italy<i>Background and Objectives</i>: We aimed to compare the time to diagnosis for acute coronary syndromes using high-sensitivity troponin I (hsTnI) and conventional troponin I (TnI) in patients presenting to the emergency department (ED) with chest pain. <i>Materials and Methods</i>: This was an observational prospective study involving patients presenting to the ED of Sant’Andrea Hospital University la Sapienza in Rome (Italy) with chest pain from January to December 2014. Serum troponin was drawn at presentation, and at 3, 6, 9, and/or 12 h if clinically indicated. Depending on date of recruitment, patients had either hsTnI (Abbott Laboratories) or TnI (Abbott Laboratories) performed. The primary endpoint was the time to diagnosis at index visit. <i>Results</i>: A total of 1059 patients were recruited, (673 [63.6%] male, median age 60 years [interquartile range 49–73 years]), out of whom 898 (84.8%) patients were evaluated with hsTnI and 161 (15.2%) with TnI. A total of 393 (37.1%) patients had the diagnosis of acute coronary syndrome in ED. The median time to diagnosis for those evaluated with TnI was 400 min, IQR 120–720 min, while the use of hsTnI led to a significantly shorter time to diagnosis (median 200 min, IQR 100–200 min, <i>p</i> < 0.001). <i>Conclusions</i>: This study confirms that in patients presenting to the emergency department with chest pain, the use of hsTnI is associated with a reduced time to ruling in/out ACS, and, consequently, hsTnI should be routinely used over TnI for more rapid identification of ACS with benefits for patients and related costs.https://www.mdpi.com/1648-9144/58/10/1391high-sensitivity troponin Iacute coronary syndrometime to diagnosisemergency department |
| spellingShingle | Ziwei Lin Patrizia Cardelli Rossella Marino Swee Han Lim Salvatore Di Somma Advantage of Using of High-Sensitivity Troponin I Compared to Conventional Troponin I in Shortening Time to Rule out/in Acute Coronary Syndrome in Chest Pain Patients Presenting to the Emergency Department Medicina high-sensitivity troponin I acute coronary syndrome time to diagnosis emergency department |
| title | Advantage of Using of High-Sensitivity Troponin I Compared to Conventional Troponin I in Shortening Time to Rule out/in Acute Coronary Syndrome in Chest Pain Patients Presenting to the Emergency Department |
| title_full | Advantage of Using of High-Sensitivity Troponin I Compared to Conventional Troponin I in Shortening Time to Rule out/in Acute Coronary Syndrome in Chest Pain Patients Presenting to the Emergency Department |
| title_fullStr | Advantage of Using of High-Sensitivity Troponin I Compared to Conventional Troponin I in Shortening Time to Rule out/in Acute Coronary Syndrome in Chest Pain Patients Presenting to the Emergency Department |
| title_full_unstemmed | Advantage of Using of High-Sensitivity Troponin I Compared to Conventional Troponin I in Shortening Time to Rule out/in Acute Coronary Syndrome in Chest Pain Patients Presenting to the Emergency Department |
| title_short | Advantage of Using of High-Sensitivity Troponin I Compared to Conventional Troponin I in Shortening Time to Rule out/in Acute Coronary Syndrome in Chest Pain Patients Presenting to the Emergency Department |
| title_sort | advantage of using of high sensitivity troponin i compared to conventional troponin i in shortening time to rule out in acute coronary syndrome in chest pain patients presenting to the emergency department |
| topic | high-sensitivity troponin I acute coronary syndrome time to diagnosis emergency department |
| url | https://www.mdpi.com/1648-9144/58/10/1391 |
| work_keys_str_mv | AT ziweilin advantageofusingofhighsensitivitytroponinicomparedtoconventionaltroponiniinshorteningtimetoruleoutinacutecoronarysyndromeinchestpainpatientspresentingtotheemergencydepartment AT patriziacardelli advantageofusingofhighsensitivitytroponinicomparedtoconventionaltroponiniinshorteningtimetoruleoutinacutecoronarysyndromeinchestpainpatientspresentingtotheemergencydepartment AT rossellamarino advantageofusingofhighsensitivitytroponinicomparedtoconventionaltroponiniinshorteningtimetoruleoutinacutecoronarysyndromeinchestpainpatientspresentingtotheemergencydepartment AT sweehanlim advantageofusingofhighsensitivitytroponinicomparedtoconventionaltroponiniinshorteningtimetoruleoutinacutecoronarysyndromeinchestpainpatientspresentingtotheemergencydepartment AT salvatoredisomma advantageofusingofhighsensitivitytroponinicomparedtoconventionaltroponiniinshorteningtimetoruleoutinacutecoronarysyndromeinchestpainpatientspresentingtotheemergencydepartment |