Prospective study of the role of cardiac troponin T in patients admitted with unstable angina

Abstract

Objective-To exane the prognostic significance and role in risk stratification of the biochemical marker troponin T in patients admitted with unstable angina.Design-Single centre, blinded, prospective study ofpatients admitted with chest pain.Setting

Classification and risk stratification of patients with acute chest pain using a low discriminatory level of cardiac troponin T

“…[1][2][3][4][5][6][7][8][9][10][11][12] An increased blood level of troponins, particularly that of cTnT, also predicts a less favorable outcome in patients with ACS. [1][2][3][4][5][6][7][8][9][10] The release of cTnT appears to indicate recent thrombotic complication of unstable plaques and identifies patients who might benefit from antithrombotic therapy with low-molecular-weight heparin 13 or glycoporotein IIb/IIIa platelet receptor antagonists. [14][15][16] According to the recent guidelines of several scientific societies, [7][8][9][10] one should measure cTn at admission and several times thereafter in patients suffering a cardiac ischemic event.…”

“…8,11 These values vary in different laboratories, and there is still no consensus on the best cut-off point values. [1][2][3][4][5][6][7][8][9][10][11][12] In earlier studies, using a first generation cTnT test, values of ≥ 0.20 or 0.10 µg/l were shown to predict an increased risk of adverse outcome. However, with such a test, Lindahl et al noted that the risk already increased with ≥ 0.06 µg/l cTnT levels.…”

Triage of acute onset chest pain: now a biochemical rule-out test?

“…Early studies demonstrated that measurement of cTnT and cTnI was superior to measurement of CK 15 or CK-MB 16 in patients with chest pain and suspected AMI.…”

“…Furthermore, higher levels of troponin are associated with increased thrombus burden within the coronary arteries, greater complexity of coronary artery lesions and reduced perfusion of the coronary bed. [14][15] Troponin elevation therefore identifies patients who benefit from more potent anti-platelet/anticoagulant and early invasive strategies. 16 Perhaps even more important in considering a rule-out test for ACS, the value of troponin extends beyond diagnostic and therapeutic decision making.…”

Recent advances in the management of unstable angina and non-Q-wave myocardial infarction

“…The heterogeneity of acute coronary syndromes be associated with a worse prognosis in unstable angina, reflects the spectrum of underlying disease but gives rise to whether or not there are changes in other cardiac enzymes two important points. Firstly, care must be taken in [9][10][11]. The prognostic influence of elevated troponin I comparing data on therapeutic efficacy in trials of unstable levels may have greater sensitivity compared with troponin angina because of differences in the selection criteria used T [12,13].…”