CARDIOVASCULAR JOURNAL OF AFRICA • Vol 24, No 1, January/February 2013
270
AFRICA
Method:
The study was conducted as a retrospective, comparative
study. Results were anonymised by using codes to protect patient
privacy. Clinical presentation was not recorded. The fourth-genera-
tion hs-cT assay (Roche Diagnostics, South Africa) was employed for
hs-cT measurements. Clinical significance of effect was evaluated on
data excluding children aged
<
12 years.
Results:
The total number of requests did not change significantly
but a significant shift in distribution of values within hs-cT catego-
ries (
<
15 ng/l; 15–52 ng/l; 53–100 ng/l;
≥
100 ng/l) was observed
(+8.6 and –22% for categories 2 and 3 respectively;
χ
2
=
21.4;
p
<
0.0001). Fourteen per cent of values exceeded 100 ng/l for both
groups. Significantly higher repeat rates were observed following
implementation of the guidelines (33 vs 42%;
χ
2
=
5.9;
p
<
0.015) as
well as lower numbers of patients within hs-cT category 2 with a
>
50% increase in hs-cT (18 vs 9%:
χ
2
=
4.9;
p
<
0.026). Thirty-five
per cent of patients within hs-cT category 3 currently present with a
>
20% increase in hs-cT. Serial daily measurements (
>
3 days) were
requested in 3% of all patients.
Conclusion:
Although this study does not specifically inform on the
use of hs-cT to diagnose MI, a change in laboratory observations is
evident. Implementation of the guidelines appears to be beneficial,
but repeat rates are still unacceptably low, irrespective of the indica-
tion for the test.
