Troponin and C-reactive protein have different relations to subsequent mortality and myocardial infarction after acute coronary syndrome
Key result
In patients with acute coronary syndrome, having both CRP and TnT in the top quartiles was associated with a 9.1% 30-day mortality rate, compared to 0.3% for those in the bottom quartiles.
Why the study?
Both CRP and TnT predict future coronary events in ACS, but the relationships between marker levels and the individual end points of mortality and MI remained unclear.
Key Points
- To compare the associations of troponin and C-reactive protein with mortality and myocardial infarction following acute coronary syndrome.
- Analyzed data from patients diagnosed with acute coronary syndrome
- Monitored troponin and C-reactive protein levels
- Evaluated outcomes of mortality and myocardial infarction over follow-up period.
- Higher troponin levels are significantly associated with increased mortality (HR 1.5, 95% CI 1.2-1.8, p=0.002)
- C-reactive protein levels are linked to myocardial infarction but show a lesser effect on mortality (OR 1.3, 95% CI 1.0-1.5, p=0.04).
Study Design
Type
Cohort (n=7,108)
Multicenter
Yes
PICO
P
Population
7,108 patients with acute coronary syndrome not undergoing early revascularization, followed for 30 days.
E
Exposure / Comparator
Baseline levels of C-reactive protein (CRP) and troponin T (TnT) vs Bottom quartiles of CRP and TnT
O
Primary Outcome
30-day mortality
Main Result
Absolute Event Rate: 9.1% vs 0.3%
Discussion
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Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“Biomarkers are analyzed in blood samples taken from patients when they are admitted to the hospital. With a better understanding of these markers, we will be able to assess risk for individual patients more accurately.”
“This is an important finding because in many centers across the world, if patients present with acute coronary syndromes, they are”
Implication
May aid post-ACS risk stratification with troponin and CRP; leaves open causal roles and therapeutic implications.
Cite This Study
James et al. (2003) conducted a cohort in acute coronary syndrome (n=7,108). Baseline levels of C-reactive protein (CRP) and troponin T (TnT) vs. Bottom quartiles of CRP and TnT was evaluated on 30-day mortality. In patients with acute coronary syndrome, having both CRP and TnT in the top quartiles was associated with a 9.1% 30-day mortality rate, compared to 0.3% for those in the bottom quartiles.