Evaluating troponin I and high-sensitivity troponin T: A comparative analysis for improved clinical decision-making

Objective: This comparative study aims to evaluate the diagnostic performance of the high-sensitive cardiac Troponin T (hs-cTnT) assay in comparison with the previous generation cardiac Troponin I (cTnI). Material and Methods: The study was conducted at Indus Hospital and Health Network's campuses between March and May 2023. Data sourced from electronic medical record system included individuals presenting to the Emergency Department (ED) with suspected Acute Myocardial Infarction (AMI). Both 4th and 5th-generation troponin assays were performed simultaneously for all participants. Statistical analyses were employed to assess the performance of each troponin assay. Results: Out of 354 patients, 205 were diagnosed with AMI. The use of the 5th-generation troponin assay resulted in a 37.9% increase in AMI diagnoses compared to the 4th-generation assay. Performance characteristics indicated that hs-Trop T exhibited significantly higher sensitivity at 99.02% than Trop I at 33.33%. Whereas, the specificity was similar for both the assays. Conclusion: This study highlights that the 5th generation assay, not only revealed a notable increase in AMI diagnoses compared to its predecessor but also underscored the extent of difference in sensitivity between both assays. This discovery carries broader implications for refining diagnostic strategies in the realm of AMI, emphasizing the need for continued exploration and validation in clinical contexts. Keywords: Myocardial infarction, Troponin assay, High sensitive troponin, Diagnostic performance study, Acute coronary syndrome