Diagnostic value of high sensitive troponin T in chest pain patients with no persistent ST-elevations

Scand Cardiovasc J. 2011 Aug;45(4):198-204. doi: 10.3109/14017431.2011.565792. Epub 2011 Mar 24.


Objectives: The aim of this study was to compare the early diagnostic value of the Roche high-sensitive troponin T (Hs-TnT) and that of conventional troponins.

Design: A total of 233 consecutive chest pain patients without ST-elevations were included. Hs-TnT was compared with two conventional assays (Roche troponin T [fourth generation] and Beckman Coulter Accu-TnI) on admission and at two hours.

Results: When acute Myocardial Infarction (MI) was defined by conventional troponins and prespecified decision limits (Hs-TnT ≥ 14 ng/l, conventional TnT ≥ 0.04 μg/l, and Accu-TnI ≥ 0.06 μg/l) were used, Hs-TnT had a higher sensitivity but a lower specificity than conventional troponins both on admission and after two hours. When the biomarkers were compared in a ROC analysis there were no significant differences with regard to AUC. When acute MI was defined by Hs-TnT, the diagnostic performance of Hs-TnT remained very high (on admission: sensitivity 96%, specificity 85%, at two hours: sensitivity 99%, specificity 83%) whereas that of conventional troponins became lower, mainly because of lower sensitivity.

Conclusion: In conclusion, when acute MI is defined by a high sensitive troponin assay, the use of Hs-TnT improves the early diagnostic accuracy compared with conventional troponins. By measuring Hs-TnT it seems possible to exclude acute MI already within the first few hours from admission.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Biological Assay / methods
  • Biomarkers / blood
  • Chest Pain / blood*
  • Diagnosis, Differential
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / blood*
  • Predictive Value of Tests
  • Prospective Studies
  • Sensitivity and Specificity
  • Troponin / blood
  • Troponin T / blood*


  • Biomarkers
  • Troponin
  • Troponin T