Diagnostic performance and prognostic value of serum troponin T in suspected acute myocardial infarction
- 1 January 1993
- journal article
- research article
- Published by Taylor & Francis in Scandinavian Journal of Clinical and Laboratory Investigation
- Vol. 53 (7) , 677-685
- https://doi.org/10.3109/00365519309092571
Abstract
Cardiac troponin T (TnT) is a new serological marker for use as a diagnostic tool for myocardial damage. A blinded prospective multicentre study representing 298 patients suspected of having acute myocardial infarction (AMI), and admitted to the coronary care units of six Scandinavian Hospitals was undertaken to assess the diagnostic performance and prognostic efficacy of a new cardiospecific TnT immunoassay. We used a discriminator TnT value of 0.20 microgram l-1. One hundred and fifty five patients (52%) had definite AMI, based on WHO criteria (all had peak S-TnT values of > or = 0.20 micrograms l-1); 127 patients (43%) had ischaemic heart disease (IHD) without AMI; and 16 patients (5%) had non-IHD (all had peak S-TnT values of < 0.20 microgram l-1). The 127 IHD-patients without definite AMI could be subdivided into a group of 44 patients with S-TnT peak values of > or = 0.20 microgram l-1, and a group of 83 patients with TnT below this level. An equal identification of these patients among the centres was seen (mean +/- SD 35 +/- 13%; range 20-55%). A follow-up study was able to define the clinical significance of these findings. The cumulative 6 months probability of suffering cardiac death or AMI was significantly higher in the subgroup with increased TnT values (14% (6/44)) as compared to the other subgroup (4% (3/83)) (Log-rank test, p = 0.025). The probability of cardiac events was 15% for the patients with definite AMI.(ABSTRACT TRUNCATED AT 250 WORDS)Keywords
This publication has 26 references indexed in Scilit:
- The Pathogenesis of Coronary Artery Disease and the Acute Coronary SyndromesNew England Journal of Medicine, 1992
- Risk Stratification in Suspected Acute Myocardial Infarction Based on a Sensitive Immunoassay for Serum Creatine Kinase Isoenzyme MBCardiology, 1992
- Gradation of unstable angina based on a sensitive immunoassay for serum creatine kinase MB.Heart, 1991
- Unstable angina: ST segment depression with positive versus negative T wave deflections—Clinical course, ECG evolution, and angiographic correlationAmerican Heart Journal, 1988
- Significance of elevated MB isoenzyme with normal creatine kinase in acute myocardial infarctionThe American Journal of Cardiology, 1987
- Elevated CK-MB with normal total creatine kinase in suspected myocardial infarction: Associated clinical findings and early prognosisAmerican Heart Journal, 1986
- Silent Ischemia as a Marker for Early Unfavorable Outcomes in Patients with Unstable AnginaNew England Journal of Medicine, 1986
- Diagnostic and prognostic significance of minimally elevated creatine kinase-mb in suspected acute myocardial infarctionThe American Journal of Cardiology, 1985
- Natural history and prognosis of unstable anginaAmerican Heart Journal, 1985
- Electrocardiographic and clinical criteria for recognition of acute myocardial infarction based on analysis of 3,697 patientsThe American Journal of Cardiology, 1983