Outcomes of patients presenting with acute coronary syndromes and negative Troponin-T.
The aim of the study was to compare need for revascularization and clinical course between troponin-positive and troponin-negative patients with unstable angina pectoris defined as class IIIB according to Braunwald classification.


METHODS
The study group consisting of 104 patients was divided into troponin-positive (28 patients) and troponin-negative (76 patients) subgroups. Per study design all patients underwent coronary angiography. The subgroups were compared in regard to angiographic status and consequently the need for revascularization. Additionally, major adverse cardiac events (MACE) consisting of death, myocardial infarction, in-hospital revascularization during 30-days follow-up were assessed in subgroups.


RESULTS
In 58 (76%) patients with negative troponin test, the angiographically significant coronary artery stenosis was shown. Major adverse cardiac events were similar in both groups. Regardless of the initial TnT status, in both groups revascularizations (percutaneous or surgical) were performed with high frequency (89 versus 72%, P=NS).


CONCLUSIONS
In patients with unstable angina in class IIIB according to Braunwald classification, the negative cardiac troponin test did not exclude severe coronary artery disease, which in the majority of patients required revascularization without any additional non-invasive testing for ischemia. Therefore, we postulate that patients with clinically evident unstable angina (IIIB) should be referred to early invasive assessment despite negative troponin T screening.
Dudek
Dariusz
D
Department of Cardiology, Institute of Cardiology Jagiellonian University College of Medicine, Krakow, Poland. mcdudek@cyf-kr.edu.pl
Chyrchel
Michal
M
Legutko
Jacek
J
Dimitrow
Pawel Petkow
PP
Zymek
Pawel
P
Kaluza
Grzegorz L
GL
Dubiel
Jacek S
JS
D000208:Acute Disease; D000368:Aged; D000789:Angina, Unstable / Q000097:blood* / Q000175:diagnosis / Q000628:therapy*; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D017063:Outcome Assessment, Health Care; D017410:Practice Guidelines as Topic; D012720:Severity of Illness Index; D013577:Syndrome; D013997:Time Factors; D020107:Troponin T / Q000097:blood*
D020107:Troponin T