Troponin T measurement after myocardial infarction can identify left ventricular ejection of less than 40%.
OBJECTIVE
To determine whether measurement of serum troponin T concentration after first acute myocardial infarction can be used to identify patients with a left ventricular ejection fraction of < 40%, who have an adverse prognosis.


METHODS
Troponin T concentration was measured, and coronary and left ventriculography performed in 50 consecutive patients with acute myocardial infarction. Angiographic left ventricular ejection fraction was compared with serum troponin T concentration. Patients with previous myocardial infarction were excluded.


RESULTS
There was a strong negative correlation between left ventricular ejection fraction and troponin T concentration. Spearman's rank correlation coefficient (corrected for ties) was -0.72 (95% confidence intervals (CI) -0.55 to -0.83; p < 0.0001). Analysis by receiver operator characteristic curve produced an area under the curve of 0.9773 (95% CI 0.9409 to 1.0136). A troponin T concentration of > 2.8 micrograms/l predicted a left ventricular ejection fraction of < 40% with a sensitivity of 100% (CI 84.6 to 100.0) and specificity of 92.9% (CI 76.5 to 99.1). Exclusion of patients who did not receive thrombolytic treatment did not significantly affect the results.


CONCLUSIONS
Serum troponin T concentration measured 12-48 hours after admission for first myocardial infarction is a reliable, simple, quick, inexpensive, non-invasive method for identifying patients with a left ventricular ejection fraction of < 40% for whom there is a poor prognosis.
Rao
A C
AC
Department of Cardiology, Mayday University Hospital, Croydon, Surrey, UK.
Collinson
P O
PO
Canepa-Anson
R
R
Joseph
S P
SP
D015415:Biomarkers / Q000097:blood; D006801:Humans; D009203:Myocardial Infarction / Q000097:blood / Q000503:physiopathology; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D020107:Troponin T / Q000097:blood*; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis*
D015415:Biomarkers; D020107:Troponin T