Novel troponin fragmentation assay to discriminate between Takotsubo syndrome and acute myocardial infarction
Authors' conclusion
In contrast to Type 1 MI, only a small fraction of circulating cTnT in TTS exists in intact or long molecular forms.
Study context
- Population
- Patients with Takotsubo syndrome or type 1 myocardial infarction (MI)
- Participants
- 24 vs 84
- Comparison
- Troponin ratio vs total cardiac troponin T (cTnT) to discriminate TTS from type 1 MI
- TTSn = 24
- Type 1 MIn = 84reference
- Outcome
- Fragmentation composition of cTnT release (troponin ratio: long to total cTnT) in TTS vs MI
Performance
As reported in the abstract
Troponin ratio
TTS
0.13
interval 0.10–0.20
Type 1 MI
0.62
interval 0.29–0.96
P < 0.001
Further findings
| Outcome | AUC (95% CI) | P value |
|---|---|---|
| Discrimination of TTS vs MI (ROC): troponin ratio vs total cTnT | 0.869 vs. 0.766 (0.789-0.948 vs. 0.677-0.855) | P = 0.047 |
| Discrimination in patients with total cTnT <1200 ng/L (ROC)Troponin ratio vs Total cTnT | 0.816 vs 0.599 (0.712-0.921 vs 0.465-0.732) | P = 0.003 |
Troponin ratio cut-off 0.12
- MI patients correctly identified
- 95%
- TTS patients correctly identified
- 50%
Original publication
Novel troponin fragmentation assay to discriminate between Takotsubo syndrome and acute myocardial infarction. Eur Heart J Acute Cardiovasc Care. Published 18 October 2024. doi:10.
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