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Journal of The Korean Society of Emergency Medicine 2026;37(3): 151-160. |
| 비ST분절상승 심근경색 환자에서 제1형 심근경색과 제2형 심근경색의 조기 감별을 위한 연속적인 고감도 트로포닌 I 검사의 유용성 |
김우현
, 강태경
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| 인제대학교 의과대학 상계백병원 응급의학과 |
| Usefulness of high-sensitivity troponin I assay in the early differentiation between type 1 and type 2 myocardial infarction |
| Woohyun Kim
, Taekyung Kang
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| Department of Emergency Medicine, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea |
| Correspondence |
Taekyung Kang ,Tel: 02-950-1119, Fax: 02-950-1932, Email: s2653@paik.ac.kr,
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Received: July 22, 2025; Revised: October 28, 2025 Accepted: November 15, 2025. Published online: June 30, 2026. |
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| ABSTRACT |
Objective:
Differentiating a type 1 myocardial infarction (T1MI) from a type 2 myocardial infarction (T2MI) is a diagnostic challenge in an emergency department (ED) setting. A high-sensitivity cardiac troponin I (hs-TnI) assay is used widely to detect myocardial injury, but its optimal temporal pattern for the early differentiation between T1MI and T2MI is unclear.
Methods:
This study evaluated the patients presenting to the ED of Inje University Sanggye Paik Hospital between June 2019 and June 2020 with the chief complaint of chest pain who underwent serial hs-TnI assay at the baseline and at 2-3 hours. The median hs-TnI values and absolute changes (Δhs-TnI) in the T1MI and T2MI groups were compared, and the diagnostic accuracy was assessed using the receiver operating characteristic curve.
Results:
Δhs-TnI was significantly greater in the T1MI group than in the T2MI group (154.4 [25.0-739.1] ng/L vs. 21.4 [0.5-118.5] ng/L; P<0.001). Moreover, the area under the curve of Δhs-TnI was 0.675.
Conclusion:
A serial hs-TnI assay might be essential for making a differential diagnosis between T1MI and T2MI in an ED setting. Nevertheless, further studies are warranted to develop diagnostic algorithms integrating troponin kinetics with underlying clinical and hemodynamic factors such as anemia, hypoxia, hypotension, or arrhythmia. |
| Key words:
Myocardial infarction; Troponin I; Biomarkers; ROC curve; Hospital emergency service |
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