title: Prognostic value of quantitative troponin T measurements in unstable angina/non-ST-segment elevation acute myocardial infarction treated early and predominantly with percutaneous coronary intervention.
abstract: OBJECTIVE
  To evaluate the effect of baseline cardiac troponin T measurements on in-hospital and long-term outcomes in patients with unstable angina/non-ST-segment elevation myocardial infarction who are treated with an early invasive strategy.
  
  
  METHODS
  We conducted a prospective cohort study involving 1024 consecutive patients with unstable angina/non-ST-segment elevation myocardial infarction. Patients were stratified according to quantitative troponin T measurements on admission, and underwent coronary angiography and subsequent coronary stenting of the culprit lesion as the primary revascularization strategy within 24 hours. The primary endpoint was all-cause mortality.
  
  
  RESULTS
  The risk of in-hospital and long-term mortality increased with absolute levels of troponin T. In-hospital mortality was 0.7% (3/449) in patients with levels <0.010 microg/L, 2.0% (4/197) in those with levels from 0.010 to 0.035 microg/L, 3.2% (6/186) in those with levels from 0.035 to 0.229 microg/L, and 4.7% (9/192) in patients with levels >0.229 microg/L. Cumulative 2-year mortality rates were 2.8%, 8.0%, 10.5%, and 14.8% from the lowest to highest troponin T groups (P <0.001). In contrast, the risk of nonfatal myocardial infarction assumed an inverted U-shaped curve and was lower in the lowest and highest troponin T groups.
  
  
  CONCLUSIONS
  Troponin T remains a strong predictor of mortality, even at low levels, in patients with unstable angina/non-ST-segment elevation myocardial infarction who are treated with early revascularization. The risk associated with elevated levels is linear for death but not for myocardial infarction.
authors.affiliation: Herz-Zentrum, Bad Krozingen, Germany. chmueller@uhbs.ch
authors.forename: Christian
authors.initials: C
authors.lastname: Mueller
authors.forename: Franz-Josef
authors.initials: FJ
authors.lastname: Neumann
authors.forename: André P
authors.initials: AP
authors.lastname: Perruchoud
authors.forename: Thomas
authors.initials: T
authors.lastname: Zeller
authors.forename: Heinz J
authors.initials: HJ
authors.lastname: Buettner
mesh_terms: D000368:Aged; D000789:Angina, Unstable / Q000097:blood* / Q000401:mortality / Q000628:therapy; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood* / Q000401:mortality / Q000628:therapy; D009204:Myocardial Revascularization; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D015607:Stents; D013577:Syndrome; D016896:Treatment Outcome; D020107:Troponin T / Q000097:blood*
chemical_list: D020107:Troponin T