Implication of different cardiac troponin I levels for clinical outcomes and prognosis of acute chest pain patients.

摘要: OBJECTIVES We compared outcomes in patients with non-ST-segment elevation acute coronary syndromes (ACS) according to the degree of cardiac troponin I (cTnI) elevation. BACKGROUND Controlled trials high-risk have found that elevations identify an even higher risk subset. It is unclear whether are similar among a lower risk, heterogeneous patient group. Also, few studies reported other than myocardial infarction (MI) or death, based on peak value. METHODS Consecutively, admitted without ST-segment initial electrocardiogram underwent serial marker sampling using creatine kinase (CK), CK-MB fraction, and cTnI. Patients were grouped cTnI: negative = no detectable cTnI; low greater limit detectability but less optimal diagnostic value; intermediate equal value manufacturer's suggested upper reference (URL); high URL. Thirty-day included MI CK-MB, revascularization, significant disease, reversible defect stress testing. Six-month mortality was also determined. Negative evaluations for ischemia nonsignificant defect, rest perfusion imaging. RESULTS Of 4,123 admitted, 893 (22%) had cTnI values. Cardiac events positive test results at 30 days 6-month increased significantly increasing inversely related Although adverse more common those cTnI, frequent. CONCLUSIONS Increased values associated worse outcomes. events, they do not same implication as values, nonischemic