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Am Heart J. 2010 Aug;160(2):224-9. doi: 10.1016/j.ahj.2010.05.023.

The new high-sensitivity cardiac troponin T assay improves risk assessment in acute coronary syndromes.

Author information

1
Department of Medical Sciences, Cardiology, and Uppsala Clinical Research Center, University of Uppsala, Uppsala, Sweden. bertil.lindahl@ucr.uu.se

Erratum in

  • Am Heart J. 2011 Feb;161(2):425.

Abstract

BACKGROUND:

Cardiac troponins are currently the markers of choice for diagnosis of acute myocardial infarction and risk assessment in acute coronary syndrome (ACS). With the introduction of the new high-sensitivity cardiac troponin T (hs-cTnT) assay, it has become possible to measure cTnT even in healthy subjects. However, how the hs-cTnT assay compares with the old cTnT assay for risk assessment in ACS is still unknown.

METHODS:

Cardiac troponin T levels were measured with the new hs-cTnT assay and the old third-generation cTnT assay in serum samples collected 48 hours after randomization in 1,452 randomly selected ACS patients enrolled in the GUSTO-IV trial. During 30 days of follow-up, deaths and myocardial infarctions were recorded. At 12 months, only all-cause mortality was collected.

RESULTS:

The 16% of the patients that had levels higher than the 99th percentile cutoff for hs-cTnT but less than for cTnT had a similar 1-year mortality as the 60% that were positive for both assays (9.2% vs 10.7%, P = .52) and a higher 1-year mortality compared with the 24% that were negative for both assays (9.2% vs 2.6%, P = .001). For death or acute myocardial infarction at 30 days, the group that was positive only for hs-cTnT had an intermediate risk compared with the groups negative or positive for both assays (2.4%, 5.2%, and 8.7%; P < .001).

CONCLUSION:

The new hs-cTnT assay, compared with the old cTnT assay, identified more patients with myocardial damage and who were at an increased risk for new cardiac events.

PMID:
20691825
DOI:
10.1016/j.ahj.2010.05.023
[Indexed for MEDLINE]

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