Applicability of cardiac troponin T and I for early risk stratification in unstable coronary artery disease. TRIM Study Group. Thrombin Inhibition in Myocardial ischemia.
BACKGROUND
Studies have demonstrated that troponin T is a strong independent indicator of a poor prognosis in patients with unstable coronary artery disease. Up to the present, no study has compared the prognostic value of troponin T with that of troponin I in the same cohort of patients.


RESULTS
Patients (n=516) suspected of having unstable coronary artery disease were investigated. Follow-up was done after 30 days, and the occurrences of cardiac death, acute myocardial infarction, refractory angina pectoris, and recurrent angina pectoris were registered. Elevated levels of troponin T (> or = 0.10 microg/L) were associated with an increased risk of cardiac death at 30 days compared with patients with normal levels, 3.2% versus 0.4% (P=.014). Troponin I values above the chosen cutoff (2.0 microg/L) were similarly found to be an indicator of increased risk of cardiac death, 3.2% versus 0.7% (P=.026). With regard to the composite end point of cardiac death/acute myocardial infarction, the troponins were strong independent indicators of adverse outcome.


CONCLUSIONS
In patients suspected of having unstable coronary artery disease, both troponin T and troponin I provide independent prognostic information with regard to cardiac death and acute myocardial infarction.
Lüscher
M S
MS
Department of Medicine and Cardiology, Aarhus University Hospital, Aarhus C, Denmark.
Thygesen
K
K
Ravkilde
J
J
Heickendorff
L
L
D000328:Adult; D000368:Aged; D000991:Antithrombins / Q000627:therapeutic use; D015331:Cohort Studies; D003327:Coronary Disease / Q000097:blood / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D005998:Glycine / Q000031:analogs & derivatives / Q000627:therapeutic use; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009206:Myocardium / Q000378:metabolism*; D017063:Outcome Assessment, Health Care; D010880:Piperidines / Q000627:therapeutic use; D011379:Prognosis; D011446:Prospective Studies; D014336:Troponin / Q000097:blood*; D019210:Troponin I / Q000097:blood*; D020107:Troponin T
D000991:Antithrombins; D010880:Piperidines; D014336:Troponin; D019210:Troponin I; D020107:Troponin T; C099871:inogatran; D006493:Heparin; D005998:Glycine