Serial and single time-point measurements of cardiac troponin T for prediction of clinical outcomes in patients with acute ST-segment elevation myocardial infarction

Clin Res Cardiol. 2009 Feb;98(2):94-100. doi: 10.1007/s00392-008-0727-9. Epub 2008 Oct 30.


Background: Cardiac troponins are the preferred biomarkers to predict infarct size in patients (pts) after acute myocardial infarction (AMI). Less information is currently available to verify the prognostic value of such a biomarker surrogate.

Methods: We included 82 pts with acute STEMI and compared all single time point and serial cardiac troponin T (cTnT) values (peak and area-under-the-curve) from admission until day 4 to predict future major adverse cardiac events (MACE).

Results: Pts who had suffered any MACE during follow-up had higher cTnT values (median (25th/75th percentiles) on day 4 (3.16 microg/l (2.71/5.20) Vs. 2.1 microg/l (1.19/3.96), P=0.0304), and higher peak cTnT values (5.11 microg/l (3.31/9.47) Vs. 2.92 microg/l (1.81/5.63), P=0.0234). The likelihood to develop a composite of MACE was twofold higher in the intermediate cTnT tertile (1.66-3.04 microg/l, n=23), and in the upper cTnT tertile (3.35-20.68 microg/l, n=23) for cTnT on day 4. For cTnT peak the risk was 1.7-fold higher in the intermediate cTnT peak tertile (2.55-5.01 microg/l, n=28) and 2.4-fold in the upper cTnT peak tertile (5.11-18.93 microg/l, n=27). The optimal ROC cutoff for cTnT to predict the composite of MACE was 2.69 microg/l measured on day 4 and 2.85 microg/l for the cTnT peak.

Conclusions: A single measurement of cTnT after STEMI is an independent predictor for MACE, performs as effective as serial cTnT sampling and may be useful to assess future events.

MeSH terms

  • Area Under Curve
  • Biomarkers / blood
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / diagnosis*
  • Myocardium / metabolism
  • Predictive Value of Tests
  • Prognosis
  • ROC Curve
  • Regression Analysis
  • Survival Rate
  • Time Factors
  • Troponin T / blood*


  • Biomarkers
  • Troponin T