The prognostic value of troponin in patients with non-ST elevation acute coronary syndromes: a meta-analysis.
J Am Coll Cardiol
; 38(2): 478-85, 2001 Aug.
Article
em En
| MEDLINE
| ID: mdl-11499741
ABSTRACT
OBJECTIVES:
This study was designed to compare the prognostic value of an abnormal troponin level derived from studies of patients with non-ST elevation acute coronary syndromes (ACS).BACKGROUND:
Risk stratification for patients with suspected ACS is important for determining need for hospitalization and intensity of treatment.METHODS:
We identified clinical trials and cohort studies of consecutive patients with suspected ACS without ST-elevation from 1966 through 1999. We excluded studies limited to patients with acute myocardial infarction and studies not reporting mortality or troponin results.RESULTS:
Seven clinical trials and 19 cohort studies reported data for 5,360 patients with a troponin T test and 6,603 with a troponin I test. Patients with positive troponin (I or T) had significantly higher mortality than those with a negative test (5.2% vs. 1.6%, odds ratio [OR] 3.1). Cohort studies demonstrated a greater difference in mortality between patients with a positive versus negative troponin I (8.4% vs. 0.7%, OR 8.5) than clinical trials (4.8% if positive, 2.1% if negative, OR 2.6, p = 0.01). Prognostic value of a positive troponin T was also slightly greater for cohort studies (11.6% mortality if positive, 1.7% if negative, OR 5.1) than for clinical trials (3.8% if positive, 1.3% if negative, OR 3.0, p = 0.2)CONCLUSIONS:
In patients with non-ST elevation ACS, the short-term odds of death are increased three- to eightfold for patients with an abnormal troponin test. Data from clinical trials suggest a lower prognostic value for troponin than do data from cohort studies.
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Base de dados:
MEDLINE
Assunto principal:
Isquemia Miocárdica
/
Troponina I
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Troponina T
/
Infarto do Miocárdio
Tipo de estudo:
Etiology_studies
/
Evaluation_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Systematic_reviews
Limite:
Aged
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
J Am Coll Cardiol
Ano de publicação:
2001
Tipo de documento:
Article
País de afiliação:
Estados Unidos