PMID- 9715236
OWN - NLM
STAT- MEDLINE
DCOM- 19980901
LR  - 20190909
IS  - 1069-6563 (Print)
IS  - 1069-6563 (Linking)
VI  - 5
IP  - 8
DP  - 1998 Aug
TI  - The prognostic significance of troponin I and troponin T.
PG  - 758-67
AB  - OBJECTIVES: To determine and compare the prognostic abilities of early, 
      single-sample measurements of cardiac troponin I (cTn-I), cardiac troponin T 
      (cTn-T), and creatine kinase-MB (CK-MB) among ED patients with possible 
      myocardial ischemia. METHODS: Prospective collection of clinical and serologic 
      data using an identity-unlinked technique from patients with possible myocardial 
      ischemia at 2 urban EDs. Outcome data concerning the occurrence of adverse events 
      (AEs) during the 14 days after enrollment were used to calculate and compare the 
      relative risks (RRs) and predictive values (with 95% confidence intervals) of the 
      3 markers for predicting AEs. RESULTS: Among the 401 study patients, 105 AEs 
      occurred in 67 patients. cTn-I, cTn-T, and CK-MB were all significantly 
      predictive of AEs, with RRs of 3.87 (2.39, 6.26), 3.03 (1.92, 4.79), and 6.45 
      (4.74, 8.77), respectively. For prediction of AEs, sensitivity for each of the 3 
      markers was low (cTn-I = 15.38, cTn-T = 24.62, CK-MB = 15.38), while specificity 
      was high (cTn-I = 97.62, cTn-T = 93.15, CK-MB = 99.70). No significant difference 
      in predictive ability was found between cTn-I and cTn-T. However, a positive 
      CK-MB result was a stronger predictor of AEs than either cTn-I (p = 0.01) or 
      cTn-T (p = 0.001). CONCLUSIONS: No significant difference in predictive abilities 
      was found between cTn-I and cTn-T. However, routine testing for both CK-MB and 
      either of the troponins may optimize early identification of high-risk patients 
      so they may be targeted for a higher level of care and consideration of more 
      aggressive therapies.
FAU - Green, G B
AU  - Green GB
AD  - Department of Emergency Medicine, Johns Hopkins Hospital, Baltimore, Maryland, 
      USA. ggreen@gwgate1.jhmi.jhu.edu
FAU - Li, D J
AU  - Li DJ
FAU - Bessman, E S
AU  - Bessman ES
FAU - Cox, J L
AU  - Cox JL
FAU - Kelen, G D
AU  - Kelen GD
FAU - Chan, D W
AU  - Chan DW
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Acad Emerg Med
JT  - Academic emergency medicine : official journal of the Society for Academic 
      Emergency Medicine
JID - 9418450
RN  - 0 (Biomarkers)
RN  - 0 (Isoenzymes)
RN  - 0 (Troponin)
RN  - 0 (Troponin I)
RN  - 0 (Troponin T)
RN  - EC 2.7.3.2 (Creatine Kinase)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Biomarkers/blood
MH  - Creatine Kinase/blood
MH  - Emergency Medical Services
MH  - Female
MH  - Humans
MH  - Isoenzymes
MH  - Male
MH  - Middle Aged
MH  - Myocardial Ischemia/*blood
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Prospective Studies
MH  - Sensitivity and Specificity
MH  - Troponin/*blood
MH  - Troponin I/*blood
MH  - Troponin T
EDAT- 1998/08/26 00:00
MHDA- 1998/08/26 00:01
CRDT- 1998/08/26 00:00
PHST- 1998/08/26 00:00 [pubmed]
PHST- 1998/08/26 00:01 [medline]
PHST- 1998/08/26 00:00 [entrez]
AID - 10.1111/j.1553-2712.1998.tb02501.x [doi]
PST - ppublish
SO  - Acad Emerg Med. 1998 Aug;5(8):758-67. doi: 10.1111/j.1553-2712.1998.tb02501.x.