Abstract
To date, acute coronary syndrome (ACS) has been mainly diagnosed on the basis of electrocardiographic changes and clinical symptoms and signs. When patients reveal no characteristic chest pain and electrocardiographic findings, it may not always be easy to reach a correct diagnosis of ACS. For the above-described reasons, myocardial biomarker measurement is becoming very important as an adjunct for the diagnosis of ACS. Patients with acute chest pain visiting the emergency room of our hospital and comprehensively diagnosed as having ACS were enrolled in this study. We compared the usefulness of high-sensitivity cardiac troponin (hs-cTn) measurement with that of H-FABP and CK-MB mass measurement. According to the results of ROC curve analysis, the AUC values were 0.955, 0.946, 0.827, and 0.896 for hs-cTnI, hs-cTnT, H-FABP, and CK-MB mass, and the cutoff values were 155.5 pg/mL, 91.0 pg/mL, 25.6 ng/mL, and 6.4 ng/mL, respectively. As a result of the test of the difference in AUC value between any two cardiac biomarkers, hs-cTns showed a higher diagnostic capability for ACS than H-FABP and CK-MB mass. In addition, CK-MB mass had a higher diagnostic capability than H-FABP. In conclusion, hs-cTnI and hs-cTnT were more organ-specific and practically more useful myocardial biomarkers for the early diagnosis and treatment of ACS than the other biomarkers tested. Whenever ACS is suspected, hs-cTns should be measured first if possible before deciding on the appropriate treatment.
