Troponin-T in unstable angina--a clinical and angiographic study.
OBJECTIVE
To examine the prognostic significance of Troponin-T in patients admitted with unstable angina and to study their angiographic morphology.


METHODS
Single centre, prospective study of in hospital events.


METHODS
Intensive coronary care unit of a large municipal general hospital.


METHODS
128 consecutive patients admitted with a diagnosis of unstable angina (Braunwald's classification).


METHODS
Measurement of Troponin-T by qualitative assay at admission, coronary angiography between 5th to 7th day.


METHODS
In hospital adverse cardiac events--recurrent angina, new myocardial infarction or cardiac deaths.


RESULTS
Fifty six (43.7%) patients had a positive test. The incidence of recurrent angina was significantly higher in the Trop-T positive group (57.1% vs 11.1%, p < 0.001). Six patients of this developed acute myocardial infarction subsequently whereas none of the patients in the Trop-T negative group developed acute MI (10.7% v/s 0%, p = 0.05). There were two deaths in the Trop-T positive group and none in the Trop-T negative group. 44 (78.5%) patients of the Trop-T positive group and 60 patients in the Trop-T negative group underwent coronary angiography. There was no significant difference in the incidence of single vessel disease (27.2% v/s 20%, p = NS) or multivessel disease (72.7% v/s 69.9%, p = ns). None of the patients with a positive Trop-T had normal coronary angiography whereas 6 patients in the Trop-T negative group had a normal coronary angiography (0% v/s 10%, p < 0.05). Patients with a positive troponin T test had a significantly higher incidence of type B lesions and a higher incidence of intracoronary thrombus.


CONCLUSIONS
The in hospital outcome of Trop-T positive patients was significantly worse than patients with a negative test. Patients with a positive troponin T test had more complex coronary morphology and a higher incidence of intracoronary thrombus. We conclude that troponin-T can be used as a prognostic marker in patients with unstable angina.
Kane
G R
GR
Department of Cardiology, LTM Medical College and LTMG Hospital Mumbai 400 022.
Keshavamurthy
C B
CB
Sethi
R B
RB
Mathew
R
R
D000328:Adult; D000368:Aged; D000789:Angina, Unstable / Q000097:blood* / Q000000981:diagnostic imaging*; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography / Q000379:methods*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D011336:Probability; D011379:Prognosis; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D020107:Troponin T / Q000097:blood*
D015415:Biomarkers; D020107:Troponin T