Abstract | BACKGROUND: METHODS: The study included 447 patients with NSTE-ACS. Cardiac troponin T ( TnT) was measured with conventional and high-sensitivity assays, in parallel, using the same plasma sample. The primary end-point was 4-year mortality. RESULTS: The use of cut-off of 0.014 μg/L of high-sensitivity TnT (hs- TnT) instead of 0.01 μg/L of the conventional (cTnT) increased proportion of non- ST-segment elevation myocardial infarction ( NSTEMI) patients by 33% (from 201 to 268 patients). Re-classified patients from unstable angina to NSTEMI had similar 4-year mortality compared to patients with NSTEMI by both assays: 16 deaths (25.1%) among 67 re-classified patients versus 47 deaths (23.6%) among patients diagnosed with NSTEMI by both assays; odds ratio=1.03, 95% confidence interval [CI] 0.53-1.97; P=0.933). The Cox model identified hsTnT (hazard ratio=2.59, 95% CI 1.22-5.50; P=0.013 for hsTnT>0.014μg/L versus hsTnT ≤ 0.014 μg/L) as an independent correlate of 4-year mortality. hsTnT significantly improved prediction of the four-year mortality (relative integrated discrimination improvement 8.2%, P=0.005). CONCLUSIONS: The use of hsTnT instead of cTnT increased the proportion of patients with NSTEMI among patients with NSTE-ACS and significantly improved risk stratification regarding long-term mortality.
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Authors | Gjin Ndrepepa, Siegmund Braun, Stefanie Schulz, Robert A Byrne, Jürgen Pache, Julinda Mehilli, Albert Schömig, Adnan Kastrati |
Journal | Clinica chimica acta; international journal of clinical chemistry
(Clin Chim Acta)
Vol. 412
Issue 15-16
Pg. 1350-6
(Jul 15 2011)
ISSN: 1873-3492 [Electronic] Netherlands |
PMID | 21497154
(Publication Type: Comparative Study, Journal Article)
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Copyright | Copyright © 2011 Elsevier B.V. All rights reserved. |
Chemical References |
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Topics |
- Acute Coronary Syndrome
(blood, diagnosis)
- Aged
- Biomarkers
(blood)
- Electrocardiography
- Female
- Humans
- Male
- Middle Aged
- Prognosis
- Sensitivity and Specificity
- Troponin T
(blood)
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