title: Cardiac troponin T and cardiac troponin I: relative values in short-term risk stratification of patients with acute coronary syndromes. GUSTO-IIa Investigators.
abstract: We compared cardiac troponins T (cTnT) and I (cTnI) collected within 3.5 h of ischemic symptoms for predicting clinical outcomes in 770 patients. cTnT (cutoff > 0.1 microgram/L) and cTnI (cutoff > 1.5 micrograms/L) were concordant (both positive or negative) in 90.4% of patients. Among discordant results, 66 were cTnT positive and cTnI negative vs 8 who showed the reverse (P < 0.001). Five cTnT-positive and cTnI-negative patients died within 30 days; none who were cTnT negative and cTnI positive died. cTnT showed a slightly greater association (chi 2 = 18.0, P < 0.001) with 30-day mortality than cTnI (chi 2 = 12.5, P = 0.002). The area of the ROC curve for predicting 30-day mortality was significantly larger (Z = 2.08; P = 0.0375) for cTnT, at 0.68 [95% confidence interval (CI) 0.60-0.75], compared with cTnI, at 0.64 (95% CI 0.56-0.72). When cTnI and the electrocardiogram (ECG) were put in a logistic multiple regression model, cTnT added significant information (chi 2 = 8.03, P = 0.045); however, cTnI did not add to a model containing cTnT and the ECG (chi 2 = 0.84, P = 0.657). cTnT provided more information than cTnI for predicting 30-day mortality early after presentation with acute coronary syndromes.
authors.affiliation: Department of Pathology, University of Maryland School of Medicine, Baltimore, USA. rchriste@umms001.ab.umd.edu
authors.forename: R H
authors.initials: RH
authors.lastname: Christenson
authors.forename: S H
authors.initials: SH
authors.lastname: Duh
authors.forename: L K
authors.initials: LK
authors.lastname: Newby
authors.forename: E M
authors.initials: EM
authors.lastname: Ohman
authors.forename: R M
authors.initials: RM
authors.lastname: Califf
authors.forename: C B
authors.initials: CB
authors.lastname: Granger
authors.forename: S
authors.initials: S
authors.lastname: Peck
authors.forename: K S
authors.initials: KS
authors.lastname: Pieper
authors.forename: P W
authors.initials: PW
authors.lastname: Armstrong
authors.forename: H A
authors.initials: HA
authors.lastname: Katus
authors.forename: E J
authors.initials: EJ
authors.lastname: Topol
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002637:Chest Pain / Q000097:blood / Q000145:classification* / Q000503:physiopathology; D003327:Coronary Disease / Q000097:blood* / Q000145:classification / Q000175:diagnosis; D004562:Electrocardiography; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000145:classification / Q000175:diagnosis*; D012044:Regression Analysis; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014336:Troponin / Q000097:blood*; D019210:Troponin I / Q000097:blood*; D020107:Troponin T
chemical_list: D015415:Biomarkers; D014336:Troponin; D019210:Troponin I; D020107:Troponin T