title: Admission troponin T as a prognostic marker and it relationship to streptokinase treatment patients with acute myocardial infarction.
abstract: The relationship between the admission troponinT (TnT) level and the response to streptokinase (SK) was examined in 76 patients with acute myocardial infarction (AMI). Of 27 TnT positive patients, 10 (37%) showed a response to SK as suggested by a non-invasive criterion for reperfusion, while 24 (49%) were 'responders' among 49 TnT negative patients. There appeared to be a trend towards a better response to SK in the TnT negative group but the difference lacked statistical power due to the small sample size. The mean time-interval between the onset of symptoms and thrombolytic treatment among TnT positive 'non-responders' was significantly (P < 0.005) higher than the TnT negative 'non-responders' (5.23 + 3.42 h versus 2.38 +/- 1.37 h). An 18 month follow up on 61 patients revealed a higher mortality (33%) among TnT positive patients than TnT negative patients (10%). Mortality among TnT positive 'non-responders' was significantly higher (P = 0.0494) than mortality among TnT-negative 'non-responders' (43% versus 9%), indicating that TnT positive patients, non-responsive to SK were at a greater risk of cardiac death. The data suggest that the admission TnT level can be of value in risk stratification of patients with AMI.
authors.affiliation: Department of Medicine, The Aga Khan University, Stadium Road, Karachi 74800, Pakistan.
authors.forename: Khawar A
authors.initials: KA
authors.lastname: Kazmi
authors.forename: M Perwaiz
authors.initials: MP
authors.lastname: Iqbal
authors.forename: Abdul
authors.initials: A
authors.lastname: Rahbar
authors.forename: Naseema
authors.initials: N
authors.lastname: Mehboobali
mesh_terms: D015415:Biomarkers / Q000097:blood; D003402:Creatine Kinase / Q000097:blood; D003955:Diagnostic Tests, Routine / Q000592:standards*; D004562:Electrocardiography; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality; D010154:Pakistan / Q000453:epidemiology; D011237:Predictive Value of Tests; D011379:Prognosis; D013300:Streptokinase / Q000627:therapeutic use*; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D005343:Fibrinolytic Agents; D020107:Troponin T; D003402:Creatine Kinase; D013300:Streptokinase