Why the study?
Does high-sensitivity cardiac troponin T (hsTnT) improve prognostic risk stratification for 30-day cardiovascular death or MI compared to fourth-generation cTnT in patients with NSTE-ACS?
Population
4,160 patients with non-ST-elevation acute coronary syndrome (NSTE-ACS)
Comparison
High-sensitivity cardiac troponin T assay vs Fourth-generation cardiac troponin T (cTnT) assay
Design
Cohort
Follow-up
30-day
Key result
Baseline high-sensitivity cardiac troponin T ≥14 ng/L was associated with a significantly higher 30-day risk of cardiovascular death or myocardial infarction compared to <14 ng/L (9.1% vs 1.9%; adjusted RR 5.2, 95% CI 2.6-10.1, P<0.0001).
Authors
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hsTnT may refine risk stratification in NSTE-ACS; leaves open effects on management decisions.
Cohort (n=4,160)
Does high-sensitivity cardiac troponin T (hsTnT) improve prognostic risk stratification for 30-day cardiovascular death or MI compared to fourth-generation cTnT in patients with NSTE-ACS?
Relative Risk: 5.2 (95% CI 2.6–10.1)
Absolute Event Rate: 9.1% vs 1.9%
p-value: p=<0.0001
High-sensitivity troponin T identifies a subset of NSTE-ACS patients with low-level troponin elevations who are at significantly increased 30-day risk of cardiovascular death or MI, who would otherwise be missed by fourth-generation assays.
Grinstein et al. (2015) conducted a cohort in Non-ST-elevation acute coronary syndrome (n=4,160). High-sensitivity cardiac troponin T (hsTnT) ≥14 ng/L vs. hsTnT <14 ng/L was evaluated on 30-day risk of cardiovascular death or myocardial infarction (RR 5.2, 95% CI 2.6-10.1, p=<0.0001). Baseline high-sensitivity cardiac troponin T ≥14 ng/L was associated with a significantly higher 30-day risk of cardiovascular death or myocardial infarction compared to <14 ng/L (9.1% vs 1.9%; adjusted RR 5.2, 95% CI 2.6-10.1, P<0.0001).