Diagnostic Efficiency and Prognostic Value of Troponin T Measurement in Acute Myocardial Infarction

The diagnosis and prognosis of patients hospitalized with acute myocardial ischemia is quite variable. We examined the value of serum levels of cardiac Troponin T, serum CK-MB levels for detection of ischemic myocardial injury and risk stratification within 40 days in patients with acute myocardial ischemia with one specimen taken 2-8 hours of the onset of symptoms. Methods We studied 141 patients with a diagnosis of acute ischemic myocardial injury. The concentration of TnT and CK-MB is made on Coobas 6000 by a electrochemioluminescence and turbidometric methods. Results The median duration of the ischemic episodes qualifying the patients for the study was 4 hours. Chest pain was continuous in 51.8% and intermittent in 48.2%. Troponin T levels were elevated in 47 % of the patients whose ischemic symptoms had lasted more than seven hours (p= 0.06). 33% of the patients had the elevated troponin T level but CK-MB level was normal. Mortality within 40 days was significantly higher in these patients than in patients with lower levels of troponin T. The troponin T level was variable and most strongly related to 40-day mortality (chi-square=23, p<0,001) followed by CK-MB (chi-square=10, p=0,005). Conclusions The cardiac troponin T level is a powerful, independent risk marker useful in the diagnosis of infarction and in the identification of patients at increased risk of mortality and morbidity.