Prognostic influence of elevated values of cardiac troponin I in patients with unstable angina

Marcello Galvani, Filippo Ottani, Donatella Ferrini, Jack H. Ladenson, Antonio Destro, Daniele Baccos, Franco Rusticali, Allan S Jaffe

Research output: Contribution to journalArticle

300 Citations (Scopus)

Abstract

Background: Elevations of the MB isoform of creatine kinase (CK) and cardiac troponin T seem to confer an adverse prognosis in unstable angina. We examined whether this prognostic influence is also present for cardiac troponin I (cTnI), a new and even more specific marker of myocardial injury. Methods and Results: We studied 106 patients with the clinical diagnosis of unstable angina showing chest discomfort at rest within 48 hours of admission. ECG evidence of myocardial ischemia, and normal values of total CK over the initial 16 hours of observation. The primary end point was death or nonfatal myocardial infarction (MI) at 30 days; the secondary end point was the incidence of cardiac events at 1 year. Blood was drawn every 8 hours for 3 days. Thirteen patients were excluded because of increased CK-MB mass concentrations within 16 hours of admission (non-Q-wave MI) and 2 because of inadequate blood sampling. Of the remaining 91 patients, 22 had cTnI elevations on admission (n=7) or after 8 hours (n=15). At 30 days, no deaths (0%) and 4 MIs (5.8%) occurred in the 69 patients with normal cTnI compared with 2 deaths (9.1%) and 4 MIs (18.2%) in the 22 patients with elevated cTnI. The combined incidence of death and nonfatal MI was 5.8% and 27.3%, respectively (P=.02). At 1 year, only 68% of patients with elevated cTnI were free of cardiac events, compared with 90% of those without elevations (P=.01). Conclusions: These data indicate that cTnI is an important prognostic variable in patients with unstable angina. Elevations of cTnI predict in adverse short- and long-term prognosis.

Original languageEnglish (US)
Pages (from-to)2053-2059
Number of pages7
JournalCirculation
Volume95
Issue number8
StatePublished - Apr 15 1997
Externally publishedYes

Fingerprint

Troponin I
Unstable Angina
MB Form Creatine Kinase
Myocardial Infarction
Troponin T
Incidence
Creatine Kinase
Myocardial Ischemia
Electrocardiography
Protein Isoforms
Reference Values
Thorax
Observation
Wounds and Injuries

Keywords

  • angina
  • myocardial infarction
  • prognosis

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Galvani, M., Ottani, F., Ferrini, D., Ladenson, J. H., Destro, A., Baccos, D., ... Jaffe, A. S. (1997). Prognostic influence of elevated values of cardiac troponin I in patients with unstable angina. Circulation, 95(8), 2053-2059.

Prognostic influence of elevated values of cardiac troponin I in patients with unstable angina. / Galvani, Marcello; Ottani, Filippo; Ferrini, Donatella; Ladenson, Jack H.; Destro, Antonio; Baccos, Daniele; Rusticali, Franco; Jaffe, Allan S.

In: Circulation, Vol. 95, No. 8, 15.04.1997, p. 2053-2059.

Research output: Contribution to journalArticle

Galvani, M, Ottani, F, Ferrini, D, Ladenson, JH, Destro, A, Baccos, D, Rusticali, F & Jaffe, AS 1997, 'Prognostic influence of elevated values of cardiac troponin I in patients with unstable angina', Circulation, vol. 95, no. 8, pp. 2053-2059.
Galvani M, Ottani F, Ferrini D, Ladenson JH, Destro A, Baccos D et al. Prognostic influence of elevated values of cardiac troponin I in patients with unstable angina. Circulation. 1997 Apr 15;95(8):2053-2059.
Galvani, Marcello ; Ottani, Filippo ; Ferrini, Donatella ; Ladenson, Jack H. ; Destro, Antonio ; Baccos, Daniele ; Rusticali, Franco ; Jaffe, Allan S. / Prognostic influence of elevated values of cardiac troponin I in patients with unstable angina. In: Circulation. 1997 ; Vol. 95, No. 8. pp. 2053-2059.
@article{6a6d1ec4a5c849c7ae14d200f3a65127,
title = "Prognostic influence of elevated values of cardiac troponin I in patients with unstable angina",
abstract = "Background: Elevations of the MB isoform of creatine kinase (CK) and cardiac troponin T seem to confer an adverse prognosis in unstable angina. We examined whether this prognostic influence is also present for cardiac troponin I (cTnI), a new and even more specific marker of myocardial injury. Methods and Results: We studied 106 patients with the clinical diagnosis of unstable angina showing chest discomfort at rest within 48 hours of admission. ECG evidence of myocardial ischemia, and normal values of total CK over the initial 16 hours of observation. The primary end point was death or nonfatal myocardial infarction (MI) at 30 days; the secondary end point was the incidence of cardiac events at 1 year. Blood was drawn every 8 hours for 3 days. Thirteen patients were excluded because of increased CK-MB mass concentrations within 16 hours of admission (non-Q-wave MI) and 2 because of inadequate blood sampling. Of the remaining 91 patients, 22 had cTnI elevations on admission (n=7) or after 8 hours (n=15). At 30 days, no deaths (0{\%}) and 4 MIs (5.8{\%}) occurred in the 69 patients with normal cTnI compared with 2 deaths (9.1{\%}) and 4 MIs (18.2{\%}) in the 22 patients with elevated cTnI. The combined incidence of death and nonfatal MI was 5.8{\%} and 27.3{\%}, respectively (P=.02). At 1 year, only 68{\%} of patients with elevated cTnI were free of cardiac events, compared with 90{\%} of those without elevations (P=.01). Conclusions: These data indicate that cTnI is an important prognostic variable in patients with unstable angina. Elevations of cTnI predict in adverse short- and long-term prognosis.",
keywords = "angina, myocardial infarction, prognosis",
author = "Marcello Galvani and Filippo Ottani and Donatella Ferrini and Ladenson, {Jack H.} and Antonio Destro and Daniele Baccos and Franco Rusticali and Jaffe, {Allan S}",
year = "1997",
month = "4",
day = "15",
language = "English (US)",
volume = "95",
pages = "2053--2059",
journal = "Circulation",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "8",

}

TY - JOUR

T1 - Prognostic influence of elevated values of cardiac troponin I in patients with unstable angina

AU - Galvani, Marcello

AU - Ottani, Filippo

AU - Ferrini, Donatella

AU - Ladenson, Jack H.

AU - Destro, Antonio

AU - Baccos, Daniele

AU - Rusticali, Franco

AU - Jaffe, Allan S

PY - 1997/4/15

Y1 - 1997/4/15

N2 - Background: Elevations of the MB isoform of creatine kinase (CK) and cardiac troponin T seem to confer an adverse prognosis in unstable angina. We examined whether this prognostic influence is also present for cardiac troponin I (cTnI), a new and even more specific marker of myocardial injury. Methods and Results: We studied 106 patients with the clinical diagnosis of unstable angina showing chest discomfort at rest within 48 hours of admission. ECG evidence of myocardial ischemia, and normal values of total CK over the initial 16 hours of observation. The primary end point was death or nonfatal myocardial infarction (MI) at 30 days; the secondary end point was the incidence of cardiac events at 1 year. Blood was drawn every 8 hours for 3 days. Thirteen patients were excluded because of increased CK-MB mass concentrations within 16 hours of admission (non-Q-wave MI) and 2 because of inadequate blood sampling. Of the remaining 91 patients, 22 had cTnI elevations on admission (n=7) or after 8 hours (n=15). At 30 days, no deaths (0%) and 4 MIs (5.8%) occurred in the 69 patients with normal cTnI compared with 2 deaths (9.1%) and 4 MIs (18.2%) in the 22 patients with elevated cTnI. The combined incidence of death and nonfatal MI was 5.8% and 27.3%, respectively (P=.02). At 1 year, only 68% of patients with elevated cTnI were free of cardiac events, compared with 90% of those without elevations (P=.01). Conclusions: These data indicate that cTnI is an important prognostic variable in patients with unstable angina. Elevations of cTnI predict in adverse short- and long-term prognosis.

AB - Background: Elevations of the MB isoform of creatine kinase (CK) and cardiac troponin T seem to confer an adverse prognosis in unstable angina. We examined whether this prognostic influence is also present for cardiac troponin I (cTnI), a new and even more specific marker of myocardial injury. Methods and Results: We studied 106 patients with the clinical diagnosis of unstable angina showing chest discomfort at rest within 48 hours of admission. ECG evidence of myocardial ischemia, and normal values of total CK over the initial 16 hours of observation. The primary end point was death or nonfatal myocardial infarction (MI) at 30 days; the secondary end point was the incidence of cardiac events at 1 year. Blood was drawn every 8 hours for 3 days. Thirteen patients were excluded because of increased CK-MB mass concentrations within 16 hours of admission (non-Q-wave MI) and 2 because of inadequate blood sampling. Of the remaining 91 patients, 22 had cTnI elevations on admission (n=7) or after 8 hours (n=15). At 30 days, no deaths (0%) and 4 MIs (5.8%) occurred in the 69 patients with normal cTnI compared with 2 deaths (9.1%) and 4 MIs (18.2%) in the 22 patients with elevated cTnI. The combined incidence of death and nonfatal MI was 5.8% and 27.3%, respectively (P=.02). At 1 year, only 68% of patients with elevated cTnI were free of cardiac events, compared with 90% of those without elevations (P=.01). Conclusions: These data indicate that cTnI is an important prognostic variable in patients with unstable angina. Elevations of cTnI predict in adverse short- and long-term prognosis.

KW - angina

KW - myocardial infarction

KW - prognosis

UR - http://www.scopus.com/inward/record.url?scp=0030936134&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030936134&partnerID=8YFLogxK

M3 - Article

C2 - 9133515

AN - SCOPUS:0030936134

VL - 95

SP - 2053

EP - 2059

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 8

ER -