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.
Keywords: Acute chest pain; Bedside troponin T; Risk stratification.