Prognostic implications of changes in cardiac troponin I levels in patients with non-ST elevation acute coronary syndrome.

ABSTRACT

OBJECTIVE: Information is limited on the prognostic implications of cardiac troponin I (cTnI) changes during the first days of non-ST elevation acute coronary syndrome (NSTE-ACS). METHODS: High-sensitivity cTnI levels were measured at study inclusion and after 48 h in 1615 conservatively managed NSTE-ACS patients from the Global Use of Strategies To Open Occluded Coronary Arteries (GUSTO) IV trial. RESULTS: Patients with moderately increased cTnI levels and without a relevant decrease over time had a significantly raised mortality at 30 days and 1 year. No relevant associations between cTnI changes and recurrent myocardial infarction were seen. CONCLUSION: The cTnI change is predictive for subsequent mortality in selected conservatively managed NSTE-ACS patients.