[Long-term prognostic value of troponin I in patients admitted to a coronary unit for unstable angina].
OBJECTIVE
Troponin I (TnI) is a useful marker of myocardial damage for the diagnosis and prognosis of acute coronary syndrome. The purpose of this study was to analyze the long-term prognostic value of the peak TnI concentration obtained within 48 h of admission to the coronary unit for unstable angina.


METHODS
The study included 149 consecutive patients. Serial determinations were made of the MB fraction of creatine kinase (CK-MB) and TnI. Patients without CK-MB elevation were classified into two groups depending on the presence of high (n = 58) or normal (n = 91) troponin I values. We prospectively analyzed the clinical and evolutive factors related to the probability of death, new acute coronary event, or coronary revascularization at one-year of follow-up.


RESULTS
There were no differences in the clinical characteristics between groups, except that patients in the group with high TnI values were older (69 vs. 64 years, p = 0.01). At one year of follow-up there were no differences in the incidence of new acute coronary events or coronary revascularization procedures; however there was a higher mortality in the group with high TnI (13 vs. 4%; p = 0.01). The independent predictors of mortality were prior myocardial infarction (RR = 3), elevated troponin I (RR = 3.2), left ventricular ejection fraction < 35% (RR = 10), and age > 70 years (RR = 15).


CONCLUSIONS
In patients with unstable angina a high troponin I value in the first 48 h of admission was associated with a higher mortality rate at one-year of follow-up.
Moríñigo
José L
JL
Servicio de Cardiología, Hospital Universitario de Salamanca, Salamanca, Spain. jlmori@eresmas.com
Sánchez
Pedro L
PL
Martín
Francisco
F
Pabón
Pedro
P
Arribas
Antonio
A
Nieto
Félix
F
Rodríguez
Javier
J
Ledesma
Claudio
C
Cascón
Manuel
M
Diego
Maximiliano
M
Martín Luengo
Cándido
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000789:Angina, Unstable / Q000097:blood / Q000175:diagnosis* / Q000401:mortality; D015415:Biomarkers / Q000097:blood; D003325:Coronary Care Units / Q000706:statistics & numerical data; D003402:Creatine Kinase / Q000097:blood; D052279:Creatine Kinase, MB Form; D005260:Female; D006801:Humans; D007527:Isoenzymes / Q000097:blood; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D016019:Survival Analysis; D013997:Time Factors; D019210:Troponin I / Q000097:blood
D015415:Biomarkers; D007527:Isoenzymes; D019210:Troponin I; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form