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High-sensitivity cardiac troponin T assay useful in clinical practice
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Introduction of a high-sensitivity cardiac troponin T assay into clinical practice resulted in the identification of minor cardiac troponin elevations in a large percentage of patients, many of whom did not have MI, according to new data from the SWEDEHEART Registry.
Researchers analyzed data on 48,594 patients in the large registry who were hospitalized for suspected ACS. All patients were classified based on high-sensitivity cardiac troponin T level: less than 6 ng/L (11.9%); 6 ng/L to 13 ng/L (13.4%); 14 ng/L to 49 ng/L (21.6%); or at least 50 ng/L (53.2%). Researchers used the Elecsys troponin T high-sensitive assay (Roche Diagnostics Corp.).
The proportion of patients with MI was 2.2% among those with a high-sensitivity cardiac troponin T level of less than 6 ng/L, 2.6% for those with a level of 6 ng/L to 13 ng/L, 18.2% for those with a level of 14 ng/L to 49 ng/L and 81.2% for those with a level of at least 50 ng/L.
Researchers observed a stepwise increase in the percentage of patients with significant coronary stenoses, left ventricular systolic dysfunction and death during follow-up, according to the study.
When patients were stratified into 20 groups based on high-sensitivity cardiac troponin T level, the data indicated an increase in adjusted mortality at a level of 14 ng/L.
“In an unselected high-risk population, a [fifth-generation] high-sensitivity cardiac troponin T assay identified a large proportion of patients with minor troponin increases not detected using the previous, less sensitive assay,” the researchers wrote. “Patients with minor cardiac troponin T increases face an increased risk of future ischemic events.” – by Jennifer Byrne
Disclosure: One researcher reports consulting for Roche Diagnostics, and two researchers report receiving honoraria from Roche Diagnostics.
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