The predictive value of the bedside troponin T test for patients with acute chest pain.
BACKGROUND
The evaluation of patients with acute chest pain is time consuming and complicated. In the present study, the role of the bedside troponin T (TnT) test was prospectively investigated for predicting the risk of death and acute heart failure (AHF) in patients with acute chest pain.


METHODS
Five hundred two consecutive patients admitted in the 24 h after the onset of chest pain were enrolled in the study. Tests of bedside TnT, qualitative troponin I, myoglobin, creatine kinase and creatine kinase (muscle-brain), and electrocardiography were performed on these patients.


RESULTS
For the bedside TnT test, 160 (31.9%) patients had positive results and 323 (64.3%) patients had negative results. During 30 days of follow-up, the differences between TnT-positive and TnT-negative patients were as follows: 139 (86.9%) positive patients and seven (2.2%) negative patients were diagnosed with acute myocardial infarction (AMI) (OR=298.8 for AMI in positive versus negative patients); 51 (31.9%) positive patients and 37 (11.5%) negative patients had AHF (OR=3.6 for AHF in positive versus negative patients); 39 (24.4%) positive patients and 15 (4.6%) negative patients died (OR=6.7 for all-cause death in positive versus negative patients); 31 (19.4%) positive patients and five (1.5%) negative patients died due to a cardiac event (OR=15.8 for cardiac death in positive versus negative patients). The sensitivity and specificity of the bedside TnT test for diagnosing AMI were 95.2% and 93.8%, respectively.


CONCLUSIONS
The bedside TnT test is a powerful, independent and valuable tool for risk stratification in patients with acute chest pain.
Guo
Xiaobi
X
Department of Cardiology, Guangzhou Red Cross Hospital, The Fourth Affiliated Hospital of Medical College of Jinan University;
Feng
Jianzhang
J
Guo
Hengshan
H