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Small changes in Troponin T levels are common in patients with non-ST-elevation myocardial infarction and are linked to higher mortality
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2013 (English)In: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 62, no 14, 1231-1238 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE:

To examine the extent of change in Troponin T levels in patients with non-ST-elevation myocardial infarction (NSTEMI).

BACKGROUND:

Changes in cardiac troponin levels are required for the diagnosis of NSTEMI, according to the new universal definition of acute myocardial infarction. A relative change of 20-230 % and an absolute change of 7- 9 ng/L have been suggested as cut-off points.

METHOD:

In a clinical setting, where a change in cTnT was not mandatory for the diagnosis of NSTEMI, serial samples of cTnT were measured with a high-sensitive cTnT (hs-cTnT) assay, and 37 clinical parameters were evaluated in 1178 patients with a final diagnosis of NSTEMI presenting <24h after symptom onset.

RESULTS:

After six hours of observation, the relative change in the hs-cTnT level remained <20 % in 26 % and the absolute change <9 ng/L in 12 % of the NSTEMI patients. A relative hs-cTnT change <20% was linked to higher long-term mortality across quartiles (p=0.002) and in multivariate analyses (HR 1.61 (1.17-2.21) p=0.004), whereas 30-day mortality was similar across quartiles of relative hs-cTnT change

CONCLUSION:

Because stable hs-TnT levels are common in patients with a clinical diagnosis of NSTEMI in our hospital, a small hs-cTnT change may not be useful to exclude NSTEMI, particularly as these patients show both short-term and long-term mortality at least as high as patients with large changes in hs-cTnT.

Place, publisher, year, edition, pages
2013. Vol. 62, no 14, 1231-1238 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-205083DOI: 10.1016/j.jacc.2013.06.050ISI: 000324689000004PubMedID: 23933541OAI: oai:DiVA.org:uu-205083DiVA: diva2:640531
Available from: 2013-08-13 Created: 2013-08-13 Last updated: 2017-12-06Bibliographically approved

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Lindahl, Bertil

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