2000, English, Article
Cardiovascular risk and therapeutic benefit of coronary interventions for patients with unstable angina according to the troponin T status
Heeschen, C.; Goldmann, B.U.; Terres, W.; ...
Aims Elevation of troponin T in patients with unstable angina is predictive of adverse outcomes. Since no advanced therapeutic concept for such high-risk patients has been established, we investigated cardiac risk prior to, during, and after coronary revascularization in patients with unstable angina stratified according to the troponin T status. Methods and Results Out of 351 patients with unstable angina, troponin was elevated for 36% of the patients as determined by qualitative bedside tests. The patients were followed during hospitalization and 30 days after discharge for incidence of death and myocardial infarction. In troponin-positive patients, clinical symptoms were more refractory to medical treatment than in troponin-negative patients (78% vs 44%; P =0·002). Although these patients were catheterized earlier (1·6 vs 3·4 days; P =0·005) and more frequently (95% vs 69%; P <0·001), troponin-positive patients suffered a higher incidence of cardiac events prior to scheduled revascularization (death, myocardial infarction; 6·4% vs 0·4%; P <0·001). The angiogram for troponin-positive patients confirmed a more severe coronary artery disease requiring revascularization (69% vs 50%; P =0·001). Also the following coronary intervention was more complicated (death, myocardial infarction; 15·3% vs 4·8%; P =0·02). During the 30-day follow-up period, cardiac risk remained elevated for troponin-positive patients. Conclusions Troponin T rapid testing reliably identified high-risk patients with unstable angina. A higher event rate was observed prior to and particularly in association with the coronary intervention. Coronary revascularization did not abrogate the increased risk of troponin-positive patients during the 30-day follow-up.
Copyright (C) 2000, European Society of Cardiology
In order to set up a list of libraries that you have access to,
you must first login
or sign up.
Then set up a personal list of libraries from your profile page by
clicking on your user name at the top right of any screen.