The long-term clinical significance of troponin and electrocardiogram in patients with unstable angina.
- Author:
Sang Hyun LEE
1
;
Myung Ho JEONG
;
Jong Soo PARK
;
Weon KIM
;
Kye Hun KIM
;
Kyung Tae KANG
;
Jay Young RHEW
;
Jong Cheol PARK
;
Young Keun AHN
;
Jeong Gwan CHO
;
Jong Chun PARK
;
Soon Pal SUH
;
Byoung Hee AHN
;
Sang Hyung KIM
;
Jung Chaee KANG
Author Information
1. The Heart Center, Chonnam National University Hospital, Chonnam National University, Gwangju, Korea.
- Publication Type:Original Article
- Keywords:
Coronary artery;
Unstable angina;
Troponin;
Major adverse cardiac events
- MeSH:
Angina, Unstable*;
Coronary Angiography;
Coronary Stenosis;
Coronary Vessels;
Depression;
Diagnosis;
Electrocardiography*;
Emergency Service, Hospital;
Follow-Up Studies;
Humans;
Jeollanam-do;
Myocardial Infarction;
Troponin I;
Troponin T;
Troponin*
- From:Korean Journal of Medicine
2001;61(5):506-517
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The early assessment of cardiac risk is important in patients with unstable angina (UA). The present study investigates the prognostic value capacities of cardiac specific troponin T (cTnT), cardiac specific troponin I (cTnI) and ECG change in Korean patients with UA. METHODS: Two hundred thirty patients (61+/-11 year, male:female=172:58) admitted to Chonnam National University Hospital via emergency room under the diagnosis of UA and underwent diagnostic coronary angiography (CAG) between July 1998 and June 1999, were analyzed according to the ECG findings of ST depression (STD), T wave inversion (TWI), cTnT and cTnI. Clinical characteristics, initial and follow-up CAG findings, and major adverse cardiac events (MACE) within one year were compared. RESULTS: Among the enrolled patients, 164 (71.3%) patients had significant coronary artery stenosis (CAS). During the one-year follow-up period, 40 patients developed MACE : 2 patients died, 7 patients had acute myocardial infarction and 34 patients developed restenosis. Positivity of cTnT and cTnI was associated with presence of CAS (p<0.001) and multi-vessel diseases (p<0.001). Levels of cTnT (5.7+/-8.4 vs 1.6+/-3.1 mg/dL, p<0.001) and cTnI (0.11+/-0.18 vs 0.03+/-0.19 mg/dL, p<0.001) were associated with MACE. The presence of STD was associated with the presence of CAS (p<0.001), multi-vessel diseases (p<0.001), low Thrombolysis In Myocardial Infarction (TIMI) flow (p<0.01), ACC/AHA types (p<0.001) and MACE (p<0.05). TWI was associated with TIMI flow (p<0.05), ACC/AHA types (p<0.001). In the patients with negative cTnT or cTnI, the negative predictive value of MACE within 1 year was 87.1% and 93.4%, respectively. In the absence of STD, that of MACE within 1 year was 87.1%. CONCLUSION: The level of troponin and electrocardiograhic findings are valuable in the early stratification of cardiac risks in Korean patients with UA and the prediction of MACE.
