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The Use of Qualitative Troponin T in the
Risk Stratification of Patients with Acute
Ischemic Syndromes Without Persistent
ST-Segment Elevation and its Usefulness
with One or two Tests; and the Differences
Between Coronary Unit and General
Intensive Unit Care
Bono, Julio O.; Fernández Cid, Gerardo;
and Investigators of the Multicentric Study
TROTESATI organized by the Coronary Unit
Committee of the Argentine Unit Care Society.
Buenos Aires. Argentina
Introduction: The quantitative and qualitative Troponin T (TNT) has shown to be a seric marker prognosis of high risk patients with Unestable Angina (UA).
Objective: To study the value of qualitative TNT, with sensitive Trop Test (TT) at the moment of the admission of patients with UA, in order to predict Hospital Ischemic Events (HIE); discriminating the usefulness of one or two TT and the results in Coronary Unit (CU) and Intensive Unit Care (IUC).
Material and Methods: It is a prospective study in 21 centers with 405 patients with Acute Ischemic Syndrome (AIS) followed between 8/16/1999 and 3/1/2001. TT was done within the 6 first hours of the beginning of angor and repeated again in those cases that were negative at first. 195 patients of CU and 184 patients of IUC were studied. The HIE evaluated were: MI Q and non Q, mortality, Pump failure and recurrent angina.
Results: TT (+) 19.8 % at first test, 26.4 % combining the result to the second test. The incidence of HIE with TT (+) changes from 66.7% to a 70% with the application of the second test in negatives (P=0.28), while the incidence with TT(-) changed from 24.7% to 19.7 % after the second test ( P< 0.05). The sensitivity (S) and specificity (E) of TT varies and it depends on where it was done: CU or IUC and also, if they used one or two TT. In CU: 1) with one TT: S 65.7%; E 92.5%. 2) with two TT: S 77.1 %; E 89.4%. In IUC: 1) with one TT: S 50.0%, E 84.7%. 2) with two TT: S 85.3%, E 82.0%.
Conclusion: The S and E of one TT in CU is higher than in IUC. A second test is suggested in those patients with the first TT(-) in the IUC, so as to discriminate the false negatives and improve dramatically the S without modifying the E.
2nd Virtual Congress of Cardiology
Dr. Florencio Garófalo
Dr. Raúl Bretal
Dr. Armando Pacher
Technical Committee - CETIFAC
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