Comparison of prognostic value of high-sensitivity and conventional troponin T in patients with non-ST-segment elevation acute coronary syndromes.

Ndrepepa, G; Braun, S; Schulz, S; Byrne, RA; Pache, J; Mehilli, J; Schömig, A; Kastrati, A

doi:10.1016/j.cca.2011.03.037

2011

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Titel:: Comparison of prognostic value of high-sensitivity and conventional troponin T in patients with non-ST-segment elevation acute coronary syndromes.
Dokumenttyp:: Comparative Study; Journal Article
Autor(en):: Ndrepepa, G; Braun, S; Schulz, S; Byrne, RA; Pache, J; Mehilli, J; Schömig, A; Kastrati, A
Abstract:: The impact of high-sensitivity troponin assays on risk stratification of patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS) is unknown.The study included 447 patients with NSTE-ACS. Cardiac troponin T (TnT) was measured with conventional and high-sensitivity assays, in parallel, using the same plasma sample. The primary end-point was 4-year mortality.The use of cut-off of 0.014 ?g/L of high-sensitivity TnT (hs-TnT) instead of 0.01 ?g/L of the conventional (cTnT) increased proportion of non-ST-segment elevation myocardial infarction (NSTEMI) patients by 33% (from 201 to 268 patients). Re-classified patients from unstable angina to NSTEMI had similar 4-year mortality compared to patients with NSTEMI by both assays: 16 deaths (25.1%) among 67 re-classified patients versus 47 deaths (23.6%) among patients diagnosed with NSTEMI by both assays; odds ratio=1.03, 95% confidence interval [CI] 0.53-1.97; P=0.933). The Cox model identified hsTnT (hazard ratio=2.59, 95% CI 1.22-5.50; P=0.013 for hsTnT>0.014?g/L versus hsTnT <= 0.014 ?g/L) as an independent correlate of 4-year mortality. hsTnT significantly improved prediction of the four-year mortality (relative integrated discrimination improvement 8.2%, P=0.005).The use of hsTnT instead of cTnT increased the proportion of patients with NSTEMI among patients with NSTE-ACS and significantly improved risk stratification regarding long-term mortality.
Zeitschriftentitel:: Clin Chim Acta
Jahr:: 2011
Band / Volume:: 412
Heft / Issue:: 15-16
Seitenangaben Beitrag:: 1350-6
Sprache:: eng
Volltext / DOI:: doi:10.1016/j.cca.2011.03.037
PubMed:: http://view.ncbi.nlm.nih.gov/pubmed/21497154
Print-ISSN:: 0009-8981
TUM Einrichtung:: I. Medizinische Klinik und Poliklinik (Kardiologie); Institut für Laboratoriumsmedizin (keine SAP-Zuordnung!)
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Lehr- und Forschungskooperationen mit den Kliniken und Instituten am Deutschen Herzzentrum Institut für Laboratoriumsmedizin (DHM) (Prof. Holdenrieder)2011

mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Klinik und Poliklinik für Innere Medizin I, Kardiologie (Prof. Laugwitz)2011