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Early prediction of risk in patients with suspected unstable angina using serum troponin T
Author(s) -
Kerr G. D.,
Dunt D. R.
Publication year - 1997
Publication title -
australian and new zealand journal of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 0004-8291
DOI - 10.1111/j.1445-5994.1997.tb00964.x
Subject(s) - medicine , troponin , odds ratio , unstable angina , cardiology , angina , troponin t , logistic regression , risk factor , troponin i , prospective cohort study , myocardial infarction
Background : One‐third of patients with rest angina are reported to have detectable cardiac troponin T in the serum and may be at increased risk of serious cardiac events. Aim : To investigate whether a single early estimation of serum troponin T was an independent predictor of serious cardiovascular complications in patients with suspected unstable angina. Methods : A prospective cohort study in which patients with suspected rest angina had a serum troponin T estimation 14 hours after symptom onset and were classified using discriminator levels of serum troponin T of 0.05 and 0.1 μg/L as well as a number of other variables. All patients were followed for six months to document any cardiac complications and a stepwise logistic regression analysis was conducted to determine independent risk factors of complications. Results : One hundred and sixty‐four patients were evaluated. Using a discriminator level of 0.05 (μg/L 54 patients (33%) had detectable troponin T. The admission ECG was the only independent predictor of cardiac events in hospital ‐ odds ratio 4.0 (95% CI 1.7–9.6). Detectable troponin T did not appear to be an independent predictor of serious complications. During the six‐month follow‐up period, detectable troponin T using a discriminator of 0.05 (μg/L was an independent predictor of serious complications ‐ odds ratio 3.7 (95% CI 1.8–7.6). Conclusions : In patients with suspected rest angina, detectable serum troponin T >0.05 (μg/L is an independent predictor of serious cardiac events during the six‐month follow‐up period although not during hospitalisation. Using a single, early serum troponin T estimation and other variables available at the time of admission, a high risk subgroup who may benefit from early investigation and revascularisation can be identified.