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October 21, 1997Circulation248 citations

Applicability of Cardiac Troponin T and I for Early Risk Stratification in Unstable Coronary Artery Disease

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MLMichael S. LüscherKTKristian ThygesenJRJan Ravkilde

Key Result

Elevated levels of troponin T (≥0.10 μg/L) and troponin I (>2.0 μg/L) were associated with an increased risk of cardiac death at 30 days compared to normal levels (3.2% vs 0.4%, P=0.014 for TnT).

Study Design

Type

Cohort (n=516)

Structured PICO

Does elevated cardiac troponin T or I predict adverse outcomes in patients suspected of having unstable coronary artery disease?

P
Population
516 patients suspected of having unstable coronary artery disease
I
Intervention
Measurement of Cardiac Troponin T and Troponin I
C
Comparator
Normal levels of troponin T (< 0.10 microg/L) and troponin I (<= 2.0 microg/L)
O
Outcome
Cardiac death at 30 dayshard clinical

Both troponin T and troponin I are strong independent indicators of adverse outcomes, specifically cardiac death and acute myocardial infarction, in patients with unstable coronary artery disease.

Main Result

Absolute Event Rate: 3.2% vs 0.4%

p-value: p=.014

Abstract

BACKGROUND: Studies have demonstrated that troponin T is a strong independent indicator of a poor prognosis in patients with unstable coronary artery disease. Up to the present, no study has compared the prognostic value of troponin T with that of troponin I in the same cohort of patients. METHODS AND RESULTS: Patients (n=516) suspected of having unstable coronary artery disease were investigated. Follow-up was done after 30 days, and the occurrences of cardiac death, acute myocardial infarction, refractory angina pectoris, and recurrent angina pectoris were registered. Elevated levels of troponin T (> or = 0.10 microg/L) were associated with an increased risk of cardiac death at 30 days compared with patients with normal levels, 3.2% versus 0.4% (P=.014). Troponin I values above the chosen cutoff (2.0 microg/L) were similarly found to be an indicator of increased risk of cardiac death, 3.2% versus 0.7% (P=.026). With regard to the composite end point of cardiac death/acute myocardial infarction, the troponins were strong independent indicators of adverse outcome. CONCLUSIONS: In patients suspected of having unstable coronary artery disease, both troponin T and troponin I provide independent prognostic information with regard to cardiac death and acute myocardial infarction.

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Cite This Study

Lüscher et al. (1997) conducted a cohort in Unstable coronary artery disease (n=516). Elevated Troponin T (≥0.10 μg/L) and Troponin I (>2.0 μg/L) vs. Normal troponin levels was evaluated on Cardiac death at 30 days (p=.014). Elevated levels of troponin T (≥0.10 μg/L) and troponin I (>2.0 μg/L) were associated with an increased risk of cardiac death at 30 days compared to normal levels (3.2% vs 0.4%, P=0.014 for TnT).

synapsesocial.com/papers/6a0ebad11c5e2d2319f9c9cahttps://doi.org/10.1161/01.cir.96.8.2578
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