Prognostic usefulness of marginal troponin T elevation

Charles A. Henrikson, Eric E. Howell, David E. Bush, J. Shawn Miles, Glenn R. Meininger, Tracy Friedlander, Andrew C. Bushnell, Nisha Chandra-Strobos

    Research output: Contribution to journalArticlepeer-review

    35 Scopus citations

    Abstract

    Marginal elevations of troponin T among patients with chest pain are often considered to be insignificant. We sought to define the prognostic value of marginal troponin T elevations in patients presenting to the emergency department with suspected myocardial ischemia. Four hundred twenty-eight consecutive patients presenting to the emergency department with ongoing chest pain were evaluated, followed through their hospital course, and contacted for follow-up 4 months after discharge. Two hundred ninety-nine patients had undetectable troponin T levels (<0.01 μg/L), 76 had marginal troponin T elevations (0.01 to 0.09 μg/L), and 53 had frank troponin T elevations (≥0.1 μg/L). Patients with either marginally or frank elevated troponin levels were older and more likely to be men, but did not differ from patients with undetectable troponin levels with regard to the prevalence of coronary artery disease risk factors, history of coronary disease, or race. While in the hospital, the undetectable and marginal troponin groups were referred for cardiac testing in equal proportions (58% and 59%, respectively), whereas 87% of the elevated group underwent further testing. After adjustment for possible confounders, a significantly increased rate of death/myocardial infarction/revascularization was observed in the marginal troponin group compared with the undetectable troponin group (p = 0.004). Marginal elevations of troponin T identified a currently underevaluated high-risk subgroup of patients with suspected myocardial ischemia who are more likely to have adverse clinical outcomes than those with undetectable troponin levels.

    Original languageEnglish (US)
    Pages (from-to)275-279
    Number of pages5
    JournalAmerican Journal of Cardiology
    Volume93
    Issue number3
    DOIs
    StatePublished - Feb 1 2004

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine

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