title: Relation between troponin T and the risk of subsequent cardiac events in unstable coronary artery disease. The FRISC study group.
abstract: BACKGROUND
  Early risk assessment is important in patients with unstable coronary artery disease, ie, unstable angina or non-Q-wave myocardial infarction. Some previous small studies have indicated that patients with unstable angina and elevation of troponin T (tn-T) have worse short-term and long-term prognoses. In this study, the prognostic value of tn-T was evaluated and compared with other early available risk indicators.
  
  
  RESULTS
  Nine hundred seventy-six patients participating in a randomized study of low-molecular-weight heparin in unstable coronary artery disease were followed for 5 months after the index episode. The risk of cardiac events increased with increasing maximal levels of tn-T obtained in the initial 24 hours. The lowest quintile (<0.06 microgram/L) constituted a low-risk group, the second quintile (0.06 to 0.18 microgram/L) an intermediate-risk group, and the three highest quintiles (> or =0.18 microgram/L) a high-risk group, with 4.3%, 10.5%, and 16.1% risk of either myocardial infarction or cardiac death, respectively. Troponin T level was identified together with age, hypertension, number of antianginal drugs, and ECG changes at rest as independent prognostic variables for myocardial infarction or cardiac death in a multivariate analysis. The prognostic value of tn-T was independent of the classification of index event into unstable angina or myocardial infarction.
  
  
  CONCLUSIONS
  Troponin T determination is an inexpensive and widely applicable method for early risk assessment in patients with unstable coronary artery disease. The maximum tn-T value obtained during the first 24 hours provides independent and important prognostic information.
authors.affiliation: Department of Cardiology, University of Uppsala, Sweden.
authors.forename: B
authors.initials: B
authors.lastname: Lindahl
authors.forename: P
authors.initials: P
authors.lastname: Venge
authors.forename: L
authors.initials: L
authors.lastname: Wallentin
mesh_terms: D000368:Aged; D000789:Angina, Unstable / Q000150:complications / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D006801:Humans; D007527:Isoenzymes; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors; D014336:Troponin / Q000097:blood*; D020107:Troponin T
chemical_list: D015415:Biomarkers; D007527:Isoenzymes; D014336:Troponin; D020107:Troponin T; D003402:Creatine Kinase