Persistent Cardiac Troponin I Elevation in Stabilized Patients After an Episode of Acute Coronary Syndrome Predicts Long-Term Mortality
Why the study?
Does persistent cardiac troponin I elevation predict long-term mortality in stabilized patients after an episode of non-ST-elevation acute coronary syndrome?
Population
1092 stabilized patients after an episode of non-ST-elevation acute coronary syndrome enrolled in the…
Comparison
Persistent cardiac troponin I elevation >0.01… vs cTnI levels ≤0.01 microg/L
Design
Cohort
Follow-up
5 years
Authors
Discussion
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Member takes
Implication
May aid post-NSTE-ACS risk stratification; leaves open whether targeting persistent elevation improves outcomes.
Key Points
- This research evaluates the prevalence and prognostic significance of persistent cardiac troponin I elevation in patients stabilized after non-ST-elevation acute coronary syndrome.
- Measured cardiac troponin I in 1092 stabilized patients at 6 weeks, 3 months, and 6 months after enrollment in the FRISC-II trial.
- Used Access AccuTnI assay with prognostic cutoffs to analyze cTnI levels.
- Conducted multivariable analysis adjusted for cardiovascular risk factors and treatment strategy.
- Elevated cTnI levels (>0.01 microg/L) found in 48% of patients at 6 weeks, 36% at 6 months, and 26% at all measurements.
- Persistent elevation was independently predictive of mortality (hazard ratio 2.1 [95% CI 1.3 to 3.3]; P=0.001).
- Minimal cTnI elevation is common and indicates increased long-term mortality risk.
Structured PICO
Does persistent cardiac troponin I elevation predict long-term mortality in stabilized patients after an episode of non-ST-elevation acute coronary syndrome?
P
Population
1092 stabilized patients after an episode of non-ST-elevation acute coronary syndrome enrolled in the FRISC-II trial
I
Intervention
Persistent cardiac troponin I (cTnI) elevation >0.01 microg/L measured at 6 weeks, 3 months, and 6 months
C
Comparator
cTnI levels ≤0.01 microg/L
O
Outcome
Mortality through 5 yearshard clinical
Persistent minor cTnI elevation (>0.01 microg/L) in stabilized patients after NSTE-ACS is an independent predictor of long-term mortality.
Cite This Study
Eggers et al. (2007) studied this question.