Format

Send to

Choose Destination
Clin Chem. 2017 Feb;63(2):552-562. doi: 10.1373/clinchem.2016.261107. Epub 2016 Dec 14.

High-Sensitivity Troponin T vs I in Acute Coronary Syndrome: Prediction of Significant Coronary Lesions and Long-term Prognosis.

Author information

1
Department of Cardiology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway.
2
Center for Heart Failure Research, University of Oslo, Norway.
3
Department of Medical Biochemistry, Oslo University Hospital, Rikshospitalet, and Institute for Clinical Medicine, University of Oslo, Norway.
4
Norwegian National Unit for newborn screening, Woman and Children's division, Oslo University Hospital, Rikshospitalet, Norway.
5
Department of Cardiology, Oslo University Hospital, Rikshospitalet, Norway.
6
Department of Cardiology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway. j.a.gravning@medisin.uio.no.

Abstract

BACKGROUND:

High-sensitivity cardiac troponin (hs-cTn) T and I assays are established as crucial tools for the diagnosis of acute myocardial infarction (AMI), as they have been found superior to old troponin assays. However, eventual differences between the assays in prediction of significant coronary lesions and long-term prognosis in patients with acute coronary syndrome (ACS) have not been fully unraveled.

METHODS:

Serum concentrations of hs-cTnT (Roche), hs-cTnI (Abbott), and amino-terminal pro-B-type natriuretic peptide (NT-proBNP; Roche) in 390 non-ST-elevation (NSTE) ACS patients were evaluated in relation to significant coronary lesions on coronary angiography (defined as a stenosis >50% of the luminal diameter, with need for revascularization) and prognostic accuracy for cardiovascular mortality, all-cause mortality, as well as the composite end point of cardiovascular mortality and hospitalizations for AMI or heart failure.

RESULTS:

The mean (SD) follow-up was 2921 (168) days. Absolute hs-cTnI concentrations were significantly higher than the hs-cTnT concentrations. The relationship between analyzed biomarkers and significant coronary lesions on coronary angiography, as quantified by the area under the ROC curve (AUC), revealed no difference between hs-cTnT [AUC, 0.81; 95% CI, 0.77-0.86] and hs-cTnI (AUC, 0.81; 95% CI, 0.76-0.86; P = NS). NT-proBNP was superior to both hs-cTn assays regarding prognostic accuracy for both cardiovascular and all-cause mortality and for the composite end point during follow-up, also in multivariate analyses.

CONCLUSIONS:

The hs-cTnT and hs-cTnI assays displayed a similar ability to predict significant coronary lesions in NSTE-ACS patients. NT-proBNP was superior to both hs-cTn assays as a marker of long-term prognosis in this patient group.

PMID:
27974383
DOI:
10.1373/clinchem.2016.261107
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for HighWire
Loading ...
Support Center