Towards a consistent definition of a significant delta troponin with z-scores: a way out of chaos?:
作者： Carel J Pretorius , Louise Cullen , William A Parsonage , Jaimi H Greenslade , Jillian R Tate
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摘要: Aims: We assessed the diagnostic performance of z-scores to define a significant delta cardiac troponin (cTn) in cohort patients with well-defined clinical outcomes. Methods: calculated z-scores, which are dependent on analytical precision and biological variation, report changes cTn. compared performances relative (%Δ), actual (Δ), 762 emergency department symptoms suspected acute coronary syndrome. cTn was measured sensitive cTnI (Beckman Coulter), highly (Abbott), cTnT (Roche) assays. Results: Receiver operating characteristic analysis showed no statistically differences areas under curve (AUC) Δ both superior %Δ for all three assays (p<0.001). The AUCs Abbott hs-cTnI (0.955) Roche hs-cTnT (0.922) were comparable Beckman Coulter (0.933) (p=0.272 0.640, respectively). individualized cut-off values that required emulate z-score 1.96 were: 30 ng/l, 20 7 ng/l. Conclusions: allow use single value at levels, assays, performances. This strategy reporting as may obviate need empirical development assay-specific rules changes.
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