Heart Fatty Acid-Binding Protein Offers Similar Diagnostic Performance to High-Sensitivity Troponin T in Emergency Room Patients Presenting With Chest Pain
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概要
- 論文の詳細を見る
Background: The aim of the present study was to evaluate the diagnostic accuracy of high-sensitivity troponin T (hsTnT) in patients with suspected acute coronary syndrome (ACS) in comparison to heart fatty acid-binding protein (H-FABP), high-sensitivity C-reactive protein, myeloperoxidase (MPO), and pentraxin 3 (PTX3). Methods and Results: Patients (n=432) with chest pain were recruited for the analysis. ACS was diagnosed in 298 patients (69%). The diagnostic accuracy of measurements obtained at presentation, as quantified by the area under the receiver operating curve (AUC), was highest for hsTnT (AUC=0.82; 95% confidence interval [CI]: 0.78-0.87) and H-FABP (AUC=0.83; 95%CI: 0.78-0.87). Sensitivity (87.9%) and negative likelihood (LH; 0.2) for hsTnT were the highest and lowest, respectively, but H-FABP had the highest specificity (78.5%) and positive LH (3.6). Among patients who presented within 2h after the onset of chest pain, MPO had the highest AUC (0.82; 95%CI: 0.69-0.94). Combined use of H-FABP and MPO measurements yielded a sensitivity of 69.2%, specificity of 84.2%, positive LH of 4.4, and negative LH of 0.4. Conclusions: The hsTnT assay offers excellent diagnostic performance to rule out ACS, but it is prone to false-positive results. H-FABP offers similar overall diagnostic performance, while the combination of H-FABP and MPO assays may improve the diagnosis of ACS, particularly in patients with recent onset of chest pain. (Circ J 2011; 75: 2813-2820)
- 社団法人 日本循環器学会の論文
- 2011-11-25
著者
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Shizuta Satoshi
Department Of Cardiovascular Medicine Graduate School Of Medicine Kyoto University
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Doi Hiroshi
Department Of Medicine And Biological Science Gunma University Graduate School Of Medicine
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Daida Hiroyuki
Department Of Cardiology Juntendo University School Of Medicine
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Daida Hiroyuki
Department Of Cardiovascular Medicine Juntendo University School Of Medicine
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Sunayama Satoshi
Department Of Cardiovascular Medicine Juntendo University School Of Medicine
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SUNAYAMA Satoshi
順天堂大学医学部 循環器内科
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Suwa Satoru
Jyuntendo Izu-nagaoka Hospital
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Suwa Satoru
Department Of Cardiology Juntendo University Shizuoka Hospital
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Itoh Seigo
Department of Cardiology, Juntendo University School of Medicine
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Itoh Seigo
Department Of Cardiology Juntendo University Shizuoka Hospital
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Itoh Seigo
Department Of Cardiology Juntendo University School Of Medicine
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Daida Hiroyuki
Department Of Cardiology
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Daida Hiroyuki
Department Of Cardiology Juntendo University
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Maruyama Sonomi
Department of Cardiology, Juntendo University Nerima Hospital
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Suwa Satoru
Department Of Cardiology Juntendo Shizuoka Hospital
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INOUE Kenji
Juntendo University Nerima Hospital
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Ohta Hiroshi
Department Od Cardiovascular Medicine Juntendo University
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Sugita Manabu
Department Of Neurology Showa General Hospital
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Inoue Kenji
Department Of Bio-system Engineering Graduate School Of Science And Engineering Yamagata University
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Maruyama Sonomi
Department Of Cardiology Juntendo Nerima Hospital
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Inoue Kenji
Laboratory For Systems Biology And Medicine Research Center For Advanced Science And Technology The
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Ohta Hiroshi
Department Of Cardiology Juntendo University Izunagaoka Hospital
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MASUDA Nobuhito
Perseus Proteomics Incorporated
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SUGITA Manabu
Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital
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