Long-Term Health Outcomes Associated with Detectable Troponin I Concentrations
- 1 February 2007
- journal article
- Published by Oxford University Press (OUP) in Clinical Chemistry
- Vol. 53 (2), 220-227
- https://doi.org/10.1373/clinchem.2006.076885
Abstract
Background: Recent data suggest that older men with detectable cardiac troponin I (cTnI) concentrations that remain below the 99th percentile concentration cutoff are at increased risk for subsequent cardiovascular events. We designed this study to extend this observation by examining risk prediction in both men and women presenting to an emergency department with chest discomfort. Methods: We obtained data for all-cause mortality and hospital discharges associated with either acute myocardial infarction (AMI) or congestive heart failure (CHF) for up to 8 years after the initial presentation in 448 patients who originally presented in 1996 with acute coronary syndrome (ACS). We performed retrospective analysis for cTnI (AccuTnI™; Beckman Coulter) in frozen plasma samples based on the patients’ reported time from onset of symptoms. Peak cTnI concentration was used for risk assessment. Results: Patients with cTnI concentrations ≥0.02 μg/L (i.e., limit of detection), including those whose peak values remained below the 99th percentile (0.04 μg/L), were at greater risk for death and AMI/CHF readmissions at 2, 5, and 8 years of follow-up compared with those with peak cTnI <0.02 μg/L. All results were statistically significant (P <0.05) except for death within 2 years among patients with normal but detectable cTnI (0.02 to 0.03 μg/L), relative to the group with values <0.02 μg/L. Kaplan–Meier analyses indicated that both men and women with cTnI ≥0.02 μg/L had worse outcomes (P <0.001). Conclusion: Both men and women who present with possible ACS with detectable cTnI concentrations that remain below the 99th percentile are at a greater risk for future adverse events.Keywords
This publication has 28 references indexed in Scilit:
- The impact of the ESC/ACC redefinition of myocardial infarction and new sensitive troponin assays on the frequency of acute myocardial infarctionAmerican Heart Journal, 2006
- Assessing the Requirement for the 6-Hour Interval between Specimens in the American Heart Association Classification of Myocardial Infarction in Epidemiology and Clinical Research StudiesClinical Chemistry, 2006
- The Antibody Configurations of Cardiac Troponin I Assays May Determine Their Clinical PerformanceClinical Chemistry, 2006
- Troponin I as a Predictor of Coronary Heart Disease and Mortality in 70-Year-Old MenCirculation, 2006
- Validation of the 99th Percentile Cutoff Independent of Assay Imprecision (CV) for Cardiac Troponin Monitoring for Ruling Out Myocardial InfarctionClinical Chemistry, 2005
- Evaluation of Imprecision for Cardiac Troponin Assays at Low-Range ConcentrationsClinical Chemistry, 2004
- Case Definitions for Acute Coronary Heart Disease in Epidemiology and Clinical Research StudiesCirculation, 2003
- Plasma 99th Percentile Reference Limits for Cardiac Troponin and Creatine Kinase MB Mass for Use with European Society of Cardiology/American College of Cardiology Consensus RecommendationsClinical Chemistry, 2003
- Clinical performance of three cardiac troponin assays in patients with unstable coronary artery disease (a FRISC II substudy)The American Journal of Cardiology, 2002
- Myocardial infarction redefined—a consensus document of The Joint European Society of Cardiology/American College of Cardiology committee for the redefinition of myocardial infarctionJournal of the American College of Cardiology, 2000