A Prospective Comparison of Cardiac Troponin T and Troponin I in the Diagnosis of Myocardial Infarction

Study Overview
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Brief Summary
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The rising number of patients with chest pain without myocardial infarction has made accurate diagnosis important. Unnecessary invasive coronary angiographies are increasingly prevalent. These are both costly and lead to rare but serious adverse events. Recent studies suggest cardiac Troponin I is more cardiac specific than cardiac Troponin T. In this study we will investigate whether using cardiac Troponin I lead to fewer unnecessary procedures in clinical practice (i.e. invasive coronary angiography and non-invasive tests)

Official Title
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A Prospective Comparison of Cardiac Troponin T and Troponin I in the Diagnosis of Myocardial Infarction

Conditions
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Myocardial Infarction

Intervention / Treatment
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* Diagnostic Test: Troponin T and I


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Admitted to either Herlev-Gentofte or Amager-Hvidovre Hospital Clinically suspected of NSTEMI Referred to invasive coronary angiography (ICA) Recieved at least one measurement of either troponin Exclusion Criteria: -
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patients treated using troponin T<br> | Diagnostic Test: Troponin T and I<br>* Does the use of troponin T or I increase the number of patients referred to coronary angiography<br>|
| Patients treated using troponin I<br> | Diagnostic Test: Troponin T and I<br>* Does the use of troponin T or I increase the number of patients referred to coronary angiography<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Specificity for MI | The difference in specificity of cardiac Troponin and I in detecting patients with significant CAD. The specificity will be defined as the proportion of patients with no significant CAD on ICA correctly identified as low-risk patients and not referred to ICA upon the review by the senior cardiologists | 0 | 
| Cost-effectiveness | The cost-effectiveness of using cardiac Troponin T compared to cardiac Troponin I. This will be defined by the number of patients sent to ICA and the associated costs of this. | 0 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Sensitivity for MI | A safety outcome of difference in sensitivity of cardiac Troponin T and cardiac Troponin I in the detection of patients with significant coronary artery disease. The sensitivity is defined as the proportion of patients with significant coronary artery disease that were referred to ICA upon review by the senior cardiologists | 0 | 
| Elevated troponin without CAD | The difference in the proportion of patients with elevated cardiac Troponin T or cardiac Troponin I above the 99th percentile with no significant CAD on ICA | 0 | 
| Number of MIs | The difference in the number of patients diagnosed with MI for each cardiac Troponin | 0 | 
| PPV and NPV | The difference in positive predictive value and negative predictive value of each cardiac Troponin | 0 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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troponin