Abstract:
BACKGROUND:Cardiac troponin T (cTnT) has been reported to be a predictor of stroke outcome. We hypothesized that the high-sensitivity cTnT (hs-cTnT) assay is superior to its previous assay generation for stroke outcome prediction. METHODS:cTnT was measured on emergency department admission in 60 consecutive patients (35 males, age 69.4 ± 13.9 years) with ischemic stroke. Adverse 90-day clinical outcome was defined as death or dependence (modified Rankin scale ≥ 3 or Barthel index < 75). RESULTS:Stroke aetiology was microangiopathy in three, macroangiopathy in 17, cardiac embolism in 26, dissection in one and unknown in 13 patients. At 90-day follow-up 16 (27%) patients had an adverse outcome. Receiver operating characteristics (ROC) curve analysis yielded a significantly better performance of hs-cTnT vs. cTnT (area under ROC curve: 0.80 [95% CI 0.68-0.89] vs. 0.70 [95% CI 0.57-0.82], p = 0.017). The optimal discriminator values according to ROC analysis were 5.1 ng/L (hs-cTnT assay) and 11 ng/L (4th generation cTnT assay) with: sensitivities 94% vs. 56%, specificities 57% vs. 84%, positive predictive values 44% vs. 56%, and negative predictive values 96% vs. 84%. CONCLUSIONS:Improvements in cTnT assay sensitivity and precision at the low measuring range resulted in a more accurate prediction of ischemic stroke outcome, particularly for ruling out worse outcome.
journal_name
Clin Chem Lab Medjournal_title
Clinical chemistry and laboratory medicineauthors
Furtner M,Ploner T,Hammerer-Lercher A,Pechlaner R,Mair Jdoi
10.1515/cclm-2012-0176subject
Has Abstractpub_date
2012-11-01 00:00:00pages
2027-9issue
11eissn
1434-6621issn
1437-4331pii
/j/cclm.ahead-of-print/cclm-2012-0176/cclm-2012-01journal_volume
50pub_type
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