Sysmex Journal International

2018Vol.28 No.1


Clinical Significance of High-sensitivity Cardiac Troponin Measurement ─ Evaluation of HISCL High-sensitivity Troponin T Reagent and Comparison of AUCs Obtained on ROC Analysis of Reagents for Myocardial Biomarkers


Hirotoshi KUZUMI*, Daiki MURAKOSHI*, Haruka KOSUGIYAMA*, Naoki AMEMIYA*,
Akihiro SONODA* and Toshio SHIMADA*

*1 Department of Clinical Laboratory Medicine, Shizuoka General Hospital,shizuoka Prefectural Hospital Organization
*2 Clinical Research Center, Shizuoka General Hospital,Shizuoka Prefectural Hospital Organization


Measurement of myocardial biomarkers as objective diagnostic indicators of acute coronary syndrome (ACS) is becoming increasingly important. Because the selection of myocardial biomarkers is affected by the size of the laboratory and the environmental requirements, various myocardial biomarkers are currently used in different laboratories. In the present study, we used Automated Immunoassay System HISCL™ (HISCL; Sysmex Corporation, Kobe, Japan) and a special reagent for HISCL, HISCL High-sensitivity Troponin T Reagent, and examined its basic performance. Moreover, we examined the usefulness of measurement of high-sensitivity cardiac troponin T and I (hs-cTnT and hs-cTnI) in diagnosing ACS by comparing this method with measurement of heart-type fatty acid-binding protein (H-FABP) and creatinine kinase muscle and brain (CK-MB) mass. Patients with an acute chest pain visiting the emergency room of our hospital and comprehensively diagnosed with ACS were enrolled to this study. The basic performance of HISCL High-sensitivity Troponin T Reagent was satisfactory, and, according to receiver operating characteristic (ROC) analysis of the samples, the AUC values of hs-cTnI, hs-cTnT, H-FABP and CK-MB mass were 0.955, 0.946, 0.827 and 0.896 respectively, while their cutoff values were 0.156 ng/mL, 0.091 ng/mL, 25.6 ng/mL and 6.4 ng/mL respectively. According to the results of comparison between the AUC values of two markers, hs-cTnI and hs-cTnT showed higher diagnostic capability for ACS than H-FABP, and CK-MB mass was a myocardial biomarker with intermediate diagnostic capability. High-sensitivity cardiac troponin should be selected as a myocardial biomarker of first choice that contributes to an early diagnosis of ACS and immediate provision of appropriate treatment.


Acute Coronary Syndrome (ACS), High-sensitivity Cardiac Troponin, Myocardial Biomaker, ROC Curve Comparison