High-Sensitivity Cardiac Troponin Risk Cutoffs for Acute Cardiac Outcomes at Emergency Department Presentation

Can J Cardiol. 2017 Jul;33(7):898-903. doi: 10.1016/j.cjca.2017.04.011. Epub 2017 May 3.

Abstract

The optimal high-sensitivity cardiac troponin (hs-cTn) cutoffs for determining risk in patients who present with acute coronary syndrome symptoms are unknown. In 1137 emergency department patients we calculated adjusted relative risks for a composite outcome (myocardial infarction, unstable angina, heart failure, ventricular arrhythmia, or cardiovascular death) within 7 days for the presentation of hs-cTnT (Roche) and hs-cTnI (Abbott) assay concentrations on the basis of literature cutoffs. Patients with hs-cTn concentrations ≥ 14 ng/L had an adjusted relative risk of 4.9 for the composite outcome, with different hs-cTnT/hs-cTnI concentration ranges yielding higher risks. A common low-risk cutoff of 14 ng/L may be used for hs-cTn with higher cutoffs identifying high-risk patients.

Trial registration: ClinicalTrials.gov NCT01994577.

Publication types

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

MeSH terms

  • Acute Disease
  • Biomarkers / blood
  • Cause of Death / trends
  • Emergency Service, Hospital*
  • Follow-Up Studies
  • Heart Diseases / blood
  • Heart Diseases / diagnosis*
  • Heart Diseases / epidemiology
  • Humans
  • Incidence
  • Ontario / epidemiology
  • Prevalence
  • Prospective Studies
  • ROC Curve
  • Reproducibility of Results
  • Risk Factors
  • Survival Rate / trends
  • Troponin I / blood*

Substances

  • Biomarkers
  • Troponin I

Associated data

  • ClinicalTrials.gov/NCT01994577

Grant support