PMID- 24037966
OWN - NLM
STAT- MEDLINE
DCOM- 20141110
LR  - 20211021
IS  - 1932-8737 (Electronic)
IS  - 0160-9289 (Print)
IS  - 0160-9289 (Linking)
VI  - 36
IP  - 11
DP  - 2013 Nov
TI  - Use of high-sensitivity troponin assays predicts mortality in patients with 
      normal conventional troponin assays on admission-insights from a meta-analysis.
PG  - 649-53
LID - 10.1002/clc.22196 [doi]
AB  - BACKGROUND: Use of high-sensitivity troponin (hs-Tn) assays can detect small 
      levels of myocardial damage previously undetectable with conventional troponin 
      (c-Tn) assays. However, prognostic utility of these hs-Tn assays in prediction of 
      mortality remains unclear in the presence of nonelevated c-Tn levels on 
      admission. A systematic review and meta-analysis was performed to assess 
      mortality risk of patients with hs-Tn elevations in the setting of normal c-Tn 
      levels. HYPOTHESIS: Patients with hs-Tn elevations with normal c-Tn levels on 
      admission blood samples, drawn to rule out acute coronary syndrome (ACS), have a 
      higher mortality risk than those without hs-Tn or c-Tn elevations. METHODS: A 
      search was made of the PubMed, CENTRAL, EMBASE, CINAHL, EBSCO, and Web of Science 
      databases. Studies evaluating patients with suspected ACS that reported mortality 
      rates for those with elevated hs-Tn levels but normal c-Tn levels on admission 
      were included. A random-effects model was used to pool event rates, and data were 
      reported in odds ratios (95% confidence interval). RESULTS: Four studies (N = 
      2033, mean age 64-75 years, 49%-70% male) revealed that nearly 32% of suspected 
      ACS patients with normal c-Tn levels on admission had elevated hs-Tn levels. 
      Elevated hs-Tn levels conferred a significantly higher risk of all-cause 
      mortality vs normal hs-Tn levels (odds ratio: 4.35, 95% confidence interval: 
      2.81-6.73, P < 0.01), with negligible heterogeneity (I(2) = 0%). CONCLUSIONS: 
      Elevation of hs-Tn levels predicted a higher risk of mortality in patients with 
      suspected ACS and may aid in the early identification of higher-risk patients in 
      this setting. Future studies are needed to investigate further optimal management 
      strategies.
CI  - (c) 2013 Wiley Periodicals, Inc.
FAU - Chatterjee, Saurav
AU  - Chatterjee S
AD  - Division of Cardiology, Providence VA Medical Center, Providence, Rhode Island; 
      Department of Medicine, Brown University, Providence, Rhode Island.
FAU - Kim, Jiwon
AU  - Kim J
FAU - Dahhan, Ali
AU  - Dahhan A
FAU - Choudhary, Gaurav
AU  - Choudhary G
FAU - Sharma, Satish
AU  - Sharma S
FAU - Wu, Wen-Chih
AU  - Wu WC
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20130827
PL  - United States
TA  - Clin Cardiol
JT  - Clinical cardiology
JID - 7903272
RN  - 0 (Biomarkers)
RN  - 0 (Troponin)
SB  - IM
MH  - Aged
MH  - Biomarkers/blood
MH  - Chi-Square Distribution
MH  - Female
MH  - Heart Diseases/*blood/diagnosis/*mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardium/*metabolism/pathology
MH  - Odds Ratio
MH  - *Patient Admission
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Risk Assessment
MH  - Risk Factors
MH  - Troponin/*blood
MH  - Up-Regulation
PMC - PMC6649604
EDAT- 2013/09/17 06:00
MHDA- 2014/11/11 06:00
PMCR- 2013/08/27
CRDT- 2013/09/17 06:00
PHST- 2013/05/31 00:00 [received]
PHST- 2013/07/15 00:00 [accepted]
PHST- 2013/09/17 06:00 [entrez]
PHST- 2013/09/17 06:00 [pubmed]
PHST- 2014/11/11 06:00 [medline]
PHST- 2013/08/27 00:00 [pmc-release]
AID - CLC22196 [pii]
AID - 10.1002/clc.22196 [doi]
PST - ppublish
SO  - Clin Cardiol. 2013 Nov;36(11):649-53. doi: 10.1002/clc.22196. Epub 2013 Aug 27.