Key result
Troponin T elevation below functional sensitivity predicts ~360% higher 6-month death and AMI risk.
Why the study?
Does adopting a lower troponin T diagnostic cut-off at the 99th percentile, below the functional sensitivity of the assay, improve prognostic stratification for adverse events in patients with suspected ACS?
Population
796 adults aged >25 years presenting to the Emergency Department of a university-affiliated teaching…
Comparison
Diagnostic troponin T cut-off at the 99th… vs Patients with undetectable troponin T.
Design
Cohort
Follow-up
6 months
Authors
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May support lower troponin T thresholds for risk stratification in suspected ACS; leaves open need for prospective validation before practice change.
Cohort (n=804)
No
Does adopting a lower troponin T diagnostic cut-off at the 99th percentile, below the functional sensitivity of the assay, improve prognostic stratification for adverse events in patients with suspected ACS?
Odds Ratio: 4.6
p-value: p=0.039
Adopting a lower troponin T cut-off at the 99th percentile, even when below the assay's functional sensitivity (CV ≤10%), identifies patients at significantly increased risk of death, AMI, and MACE at 6 months.
Body et al. (2010) conducted a cohort in Suspected ACS (n=804). Troponin T elevation below the functional sensitivity vs. Negative troponin was evaluated on Death or AMI (excluding the index event) (OR 4.6, p=0.039). Troponin T elevation below the functional sensitivity independently predicted the risk of death and AMI (adjusted OR 4.6, p=0.039) and MACE (adjusted OR 11.10, p<0.0001) at 6 months.
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