(Circulation. 1997;96:2578-2585.)
© 1997 American Heart Association, Inc.
Articles |
Applicability of Cardiac Troponin T and I for Early Risk Stratification in Unstable Coronary Artery Disease
From the Department of Medicine and Cardiology (M.S.L., K.T., J.R.) and Department of Clinical Biochemistry (L.H.), Aarhus University Hospital, Denmark.
Correspondence to Michael Stausbøll Lüscher, Department of Medicine and Cardiology, Aarhus University Hospital, Tage Hansens Gade 2, DK-8000 Aarhus C, Denmark.
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 (
0.10
µg/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
µg/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.
Key Words: prognosis • myocardial infarction • angina • troponin
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