Document Detail


Long-term health outcomes associated with detectable troponin I concentrations.
MedLine Citation:
PMID:  17204519     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Recent data suggest that older men with detectable cardiac troponin I (cTnI) concentrations that remain below the 99th percentile concentration cutoff are at increased risk for subsequent cardiovascular events. We designed this study to extend this observation by examining risk prediction in both men and women presenting to an emergency department with chest discomfort. METHODS: We obtained data for all-cause mortality and hospital discharges associated with either acute myocardial infarction (AMI) or congestive heart failure (CHF) for up to 8 years after the initial presentation in 448 patients who originally presented in 1996 with acute coronary syndrome (ACS). We performed retrospective analysis for cTnI (AccuTnI; Beckman Coulter) in frozen plasma samples based on the patients' reported time from onset of symptoms. Peak cTnI concentration was used for risk assessment. RESULTS: Patients with cTnI concentrations > or =0.02 microg/L (i.e., limit of detection), including those whose peak values remained below the 99th percentile (0.04 microg/L), were at greater risk for death and AMI/CHF readmissions at 2, 5, and 8 years of follow-up compared with those with peak cTnI <0.02 microg/L. All results were statistically significant (P <0.05) except for death within 2 years among patients with normal but detectable cTnI (0.02 to 0.03 microg/L), relative to the group with values <0.02 microg/L. Kaplan-Meier analyses indicated that both men and women with cTnI > or =0.02 microg/L had worse outcomes (P <0.001). CONCLUSION: Both men and women who present with possible ACS with detectable cTnI concentrations that remain below the 99th percentile are at a greater risk for future adverse events.
Authors:
Peter A Kavsak; Alice M Newman; Viliam Lustig; Andrew R MacRae; Glenn E Palomaki; Dennis T Ko; Jack V Tu; Allan S Jaffe
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-01-04
Journal Detail:
Title:  Clinical chemistry     Volume:  53     ISSN:  0009-9147     ISO Abbreviation:  Clin. Chem.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-01-29     Completed Date:  2007-03-12     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9421549     Medline TA:  Clin Chem     Country:  United States    
Other Details:
Languages:  eng     Pagination:  220-7     Citation Subset:  IM    
Affiliation:
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada. kavsakp@mcmaster.ca
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiovascular Diseases / diagnosis,  mortality*
Chest Pain / diagnosis
Female
Heart Failure / diagnosis,  mortality
Humans
Male
Middle Aged
Myocardial Infarction / diagnosis,  mortality
Retrospective Studies
Risk
Survival Analysis
Troponin I / blood*
Chemical
Reg. No./Substance:
0/Troponin I

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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