High-sensitivity cardiac troponin T is superior to troponin I in the prediction of mortality in patients without acute coronary syndrome.
Int J Cardiol
; 259: 186-191, 2018 05 15.
Article
em En
| MEDLINE
| ID: mdl-29477263
ABSTRACT
BACKGROUND:
Differences in prevalence and prognostic information of cardiac troponin T (cTnT) and I (cTnI) concentrations in patients without acute coronary syndrome (ACS) are insufficiently investigated. High-sensitivity assays (hs-cTn) have led to an increased interest in hs-cTn for risk stratification. Here, we compare hs-cTnT and hs-cTnI in prediction of mortality patients without ACS. METHOD ANDRESULTS:
Patients aged >18â¯years, consecutively admitted to an emergency department (ED) were included. Blood was collected at admission and later analyzed with high-sensitivity assays for cTnT (Roche) and cTnI (Siemens). Troponin concentrations were reported as normal or increased according to the clinical cut-off value of 99th percentile as defined by the manufacturer. The primary outcome was all-cause mortality. Of the 822 participants (median, 65â¯years [48-77]; 428 female [52%]), 239 patients died. Median follow-up time was 3.0â¯years [2.1-3.0]. Elevation of hs-cTn was observed in 40% (nâ¯=â¯345) for hs-cTnT and 8% (nâ¯=â¯64) for hs-cTnI, pâ¯<â¯0.001. The relationship between elevated hs-cTn and mortality was strong for both hs-cTnT and hs-cTnI [HR 6.0 (95%CI 2.9-12.6) vs. 5.1 (95%CI 1.9-13.6)].There was no difference in prognostic accuracy for short-term mortality (30â¯days) between hs-cTnT and hs-cTnI. However, the prognostic accuracy for long-term mortality (1080â¯days) was superior for hs-cTnT than for hs-cTnI [area under the receivers operating curve (AUC) 0.81 vs 0.74, pâ¯<â¯0.001].CONCLUSION:
Both hs-cTnI and hs-cTnT were predictive for all-cause mortality. Notably, hs-cTnT measurement showed superior prognostic performance in predicting long-term all-cause mortality compared with hs-cTnI.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Causas de Morte
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Troponina I
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Troponina T
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Serviço Hospitalar de Emergência
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Síndrome Coronariana Aguda
Tipo de estudo:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article