Applicability of cardiac troponin T and I for early risk stratification in unstable coronary artery disease. TRIM Study Group. Thrombin Inhibition in Myocardial ischemia

Circulation. 1997 Oct 21;96(8):2578-85. doi: 10.1161/01.cir.96.8.2578.

Abstract

Background: Studies have demonstrated that troponin T is a strong independent indicator of a poor prognosis in patients with unstable coronary artery disease. Up to the present, no study has compared the prognostic value of troponin T with that of troponin I in the same cohort of patients.

Methods and results: Patients (n=516) suspected of having unstable coronary artery disease were investigated. Follow-up was done after 30 days, and the occurrences of cardiac death, acute myocardial infarction, refractory angina pectoris, and recurrent angina pectoris were registered. Elevated levels of troponin T (> or = 0.10 microg/L) were associated with an increased risk of cardiac death at 30 days compared with patients with normal levels, 3.2% versus 0.4% (P=.014). Troponin I values above the chosen cutoff (2.0 microg/L) were similarly found to be an indicator of increased risk of cardiac death, 3.2% versus 0.7% (P=.026). With regard to the composite end point of cardiac death/acute myocardial infarction, the troponins were strong independent indicators of adverse outcome.

Conclusions: In patients suspected of having unstable coronary artery disease, both troponin T and troponin I provide independent prognostic information with regard to cardiac death and acute myocardial infarction.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antithrombins / therapeutic use
  • Cohort Studies
  • Coronary Disease / blood
  • Coronary Disease / metabolism
  • Coronary Disease / physiopathology*
  • Female
  • Glycine / analogs & derivatives
  • Glycine / therapeutic use
  • Heparin / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Myocardium / metabolism*
  • Outcome Assessment, Health Care
  • Piperidines / therapeutic use
  • Prognosis
  • Prospective Studies
  • Troponin / blood*
  • Troponin I / blood*
  • Troponin T

Substances

  • Antithrombins
  • Piperidines
  • Troponin
  • Troponin I
  • Troponin T
  • inogatran
  • Heparin
  • Glycine