Document Detail


Sensitive troponin assay predicts outcome in syncope.
MedLine Citation:
PMID:  22962048     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: To assess whether plasma troponin concentration measured by a sensitive assay can predict 1-month and 1-year serious outcome, or all-cause death in patients presenting with syncope to the emergency department (ED).
METHODS: Prospective cohort study of admitted adult patients presenting to the ED after an episode of syncope who had plasma troponin measured 12 h after syncope using the ARCHITECT STAT sensitive troponin I assay (Abbott Diagnostics). Primary endpoints were the composite endpoint of serious outcome or all-cause death at 1 month and 1 year.
RESULTS: Between 1 March 2007 and 22 July 2008, 338 of 528 patients admitted from the ED with syncope had plasma troponin concentrations determined. Troponin concentrations were above the limit of detection in 261 (77%) patients. Patients numbering 120 (36%) had a troponin concentration ≥0.03 ng/ml (99th percentile of normal reference population), and 66 (20%) had concentrations ≥0.05 ng/ml (local diagnostic threshold for myocardial infarction). The proportion of patients with a composite serious outcome increased across patients stratified into quintiles based on peak troponin concentration at 1 month (0%, 9%, 13%, 26%, 70%) and at 1 year (10%, 22%, 26%, 52%, 85%).
CONCLUSIONS: The majority of patients admitted from the ED with syncope have detectable plasma troponin concentrations. Peak troponin concentration was associated with increasing risk of serious outcome and death, and this risk increases with higher troponin concentrations. Troponin may have a future role in the risk stratification of patients with syncope.
Authors:
Matthew J Reed; Nicholas L Mills; Christopher J Weir
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-09-08
Journal Detail:
Title:  Emergency medicine journal : EMJ     Volume:  29     ISSN:  1472-0213     ISO Abbreviation:  Emerg Med J     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-26     Completed Date:  2013-05-09     Revised Date:  2014-02-20    
Medline Journal Info:
Nlm Unique ID:  100963089     Medline TA:  Emerg Med J     Country:  England    
Other Details:
Languages:  eng     Pagination:  1001-3     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Biological Markers / blood
Emergency Medicine / methods
Emergency Service, Hospital
Female
Humans
Male
Middle Aged
Outcome Assessment (Health Care)
Predictive Value of Tests
Prospective Studies
Scotland
Sensitivity and Specificity
Syncope / blood*,  mortality
Troponin / blood*
Young Adult
Grant Support
ID/Acronym/Agency:
CSO/CAF/06/01//Chief Scientist Office; FS/10/024/28266//British Heart Foundation
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Troponin

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


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