Relative utility of serum troponin and the OESIL score in syncope

Emerg Med Australas. 2005 Feb;17(1):31-8. doi: 10.1111/j.1742-6731.2005.00678.x.


Objective: To investigate the utility of both a random troponin T level taken greater than 4 h after a syncopal event and the Osservatorio Epidemiologico sulla Sincope nel Lazio (OESIL) score in predicting outcome post syncope.

Methods: We prospectively enrolled 113 adult patients who presented to our ED after a syncopal event. Each patient had a troponin T level taken at least 4 h after the event. The relevant history of the syncope, background medical history and ECG were collected at presentation. Patients were followed up via telephone after 3-6 months and medical records were also examined. The OESIL risk score was calculated for each patient and the predictive value of both the troponin T and OESIL score were analysed for their utility post syncope.

Results: Data were analysed for 100 patients. Twenty percent were believed to have a cardiac cause for their syncope. An elevated troponin T level was found to be highly specific (0.99, 95% confidence interval [CI] 0.96-1.0) for adverse cardiac outcome, but with a very low sensitivity (0.13, 95% CI 0-0.3). The OESIL risk score was found to be predictive of an adverse cardiac outcome (receiver-operating characteristic [ROC] 0.73, 95% CI 0.63-0.84) and return to normal function (ROC 0.74, 95% CI 0.63-0.86).

Conclusions: A normal serum troponin T has a poor negative predictive value for adverse cardiac outcomes following syncope. A simple risk stratification system, such as the OESIL score, can predict those patients most at risk after a syncopal episode.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Emergency Medicine / methods*
  • Emergency Medicine / statistics & numerical data
  • Female
  • Heart Diseases / blood
  • Heart Diseases / complications
  • Heart Diseases / diagnosis
  • Humans
  • Male
  • Middle Aged
  • New South Wales
  • Outcome Assessment, Health Care
  • Patient Admission / statistics & numerical data
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies
  • Risk Factors
  • Severity of Illness Index*
  • Survival Analysis
  • Syncope / blood*
  • Syncope / diagnosis*
  • Syncope / etiology
  • Troponin / blood*


  • Troponin