Lüscher M S, Thygesen K, Ravkilde J, Heickendorff L
Department of Medicine and Cardiology, Aarhus University Hospital, Aarhus C, Denmark.
Circulation. 1997 Oct 21;96(8):2578-85. doi: 10.1161/01.cir.96.8.2578.
Studies have demonstrated that troponin T is a strong independent indicator of a poor prognosis in patients with unstable coronary artery disease. Up to the present, no study has compared the prognostic value of troponin T with that of troponin I in the same cohort of patients.
Patients (n=516) suspected of having unstable coronary artery disease were investigated. Follow-up was done after 30 days, and the occurrences of cardiac death, acute myocardial infarction, refractory angina pectoris, and recurrent angina pectoris were registered. Elevated levels of troponin T (> or = 0.10 microg/L) were associated with an increased risk of cardiac death at 30 days compared with patients with normal levels, 3.2% versus 0.4% (P=.014). Troponin I values above the chosen cutoff (2.0 microg/L) were similarly found to be an indicator of increased risk of cardiac death, 3.2% versus 0.7% (P=.026). With regard to the composite end point of cardiac death/acute myocardial infarction, the troponins were strong independent indicators of adverse outcome.
In patients suspected of having unstable coronary artery disease, both troponin T and troponin I provide independent prognostic information with regard to cardiac death and acute myocardial infarction.
研究表明，肌钙蛋白T是不稳定型冠状动脉疾病患者预后不良的一个强有力的独立指标。到目前为止，尚无研究在同一组患者中比较肌钙蛋白T和肌钙蛋白I的预后价值。
对516例疑似不稳定型冠状动脉疾病的患者进行了调查。在30天后进行随访，并记录心脏死亡、急性心肌梗死、难治性心绞痛和复发性心绞痛的发生情况。与肌钙蛋白T水平正常的患者相比，肌钙蛋白T水平升高（≥0.10μg/L）与30天时心脏死亡风险增加相关，分别为3.2%和0.4%（P = 0.014）。同样发现，肌钙蛋白I值高于选定的临界值（2.0μg/L）是心脏死亡风险增加的一个指标，分别为3.2%和0.7%（P = 0.026）。关于心脏死亡/急性心肌梗死的复合终点，肌钙蛋白是不良结局的强有力独立指标。
在疑似不稳定型冠状动脉疾病的患者中，肌钙蛋白T和肌钙蛋白I均能提供关于心脏死亡和急性心肌梗死的独立预后信息。
