Serial troponin-I and long-term outcomes in subjects with suspected acute coronary syndrome
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Serial troponin-I and long-term outcomes in subjects with suspected acute coronary syndrome. / Pareek, Manan; Kristensen, Anna Meta Dyrvig; Vaduganathan, Muthiah; Byrne, Christina; Biering-Sørensen, Tor; Højbjerg Lassen, Mats Christian; Johansen, Niklas Dyrby; Skaarup, Kristoffer Grundtvig; Rosberg, Victoria; Pallisgaard, Jannik L.; Mortensen, Martin Bødtker; Maeng, Michael; Polcwiartek, Christoffer B.; Frangeskos, Julia; McCarthy, Cian P.; Bonde, Anders Nissen; Lee, Christina Ji Young; Fosbøl, Emil L.; Køber, Lars; Olsen, Niels Thue; Gislason, Gunnar H.; Torp-Pedersen, Christian; Bhatt, Deepak L.; Kragholm, Kristian H.
In: European Journal of Preventive Cardiology, Vol. 31, No. 5, 2024, p. 615-626.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Serial troponin-I and long-term outcomes in subjects with suspected acute coronary syndrome
AU - Pareek, Manan
AU - Kristensen, Anna Meta Dyrvig
AU - Vaduganathan, Muthiah
AU - Byrne, Christina
AU - Biering-Sørensen, Tor
AU - Højbjerg Lassen, Mats Christian
AU - Johansen, Niklas Dyrby
AU - Skaarup, Kristoffer Grundtvig
AU - Rosberg, Victoria
AU - Pallisgaard, Jannik L.
AU - Mortensen, Martin Bødtker
AU - Maeng, Michael
AU - Polcwiartek, Christoffer B.
AU - Frangeskos, Julia
AU - McCarthy, Cian P.
AU - Bonde, Anders Nissen
AU - Lee, Christina Ji Young
AU - Fosbøl, Emil L.
AU - Køber, Lars
AU - Olsen, Niels Thue
AU - Gislason, Gunnar H.
AU - Torp-Pedersen, Christian
AU - Bhatt, Deepak L.
AU - Kragholm, Kristian H.
N1 - Publisher Copyright: © 2023 The Author(s). Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved.
PY - 2024
Y1 - 2024
N2 - Aims: It is unclear how serial high-sensitivity troponin-I (hsTnI) concentrations affect long-term prognosis in individuals with suspected acute coronary syndrome (ACS). Methods and results: Subjects who underwent two hsTnI measurements (Siemens TnI Flex® Reagent) separated by 1-7 h, during a first-time hospitalization for myocardial infarction, unstable angina, observation for suspected myocardial infarction, or chest pain from 2012 through 2019, were identified through Danish national registries. Individuals were stratified per their hsTnI concentration pattern (normal, rising, persistently elevated, or falling) and the magnitude of hsTnI concentration change (<20%, >20-50%, or >50% in either direction). We calculated absolute and relative mortality risks standardized to the distributions of risk factors for the entire study population. A total of 20 609 individuals were included of whom 2.3% had died at 30 days, and an additional 4.7% had died at 365 days. The standardized risk of death was highest among persons with a persistently elevated hsTnI concentration (0-30 days: 8.0%, 31-365 days: 11.1%) and lowest among those with two normal hsTnI concentrations (0-30 days: 0.5%, 31-365 days: 2.6%). In neither case did relative hsTnI concentration changes between measurements clearly affect mortality risk. Among persons with a rising hsTnI concentration pattern, 30-day mortality was higher in subjects with a >50% rise compared with those with a less pronounced rise (2.2% vs. <0.1%). Conclusion: Among individuals with suspected ACS, those with a persistently elevated hsTnI concentration consistently had the highest risk of death. In subjects with two normal hsTnI concentrations, mortality was very low and not affected by the magnitude of change between measurements.
AB - Aims: It is unclear how serial high-sensitivity troponin-I (hsTnI) concentrations affect long-term prognosis in individuals with suspected acute coronary syndrome (ACS). Methods and results: Subjects who underwent two hsTnI measurements (Siemens TnI Flex® Reagent) separated by 1-7 h, during a first-time hospitalization for myocardial infarction, unstable angina, observation for suspected myocardial infarction, or chest pain from 2012 through 2019, were identified through Danish national registries. Individuals were stratified per their hsTnI concentration pattern (normal, rising, persistently elevated, or falling) and the magnitude of hsTnI concentration change (<20%, >20-50%, or >50% in either direction). We calculated absolute and relative mortality risks standardized to the distributions of risk factors for the entire study population. A total of 20 609 individuals were included of whom 2.3% had died at 30 days, and an additional 4.7% had died at 365 days. The standardized risk of death was highest among persons with a persistently elevated hsTnI concentration (0-30 days: 8.0%, 31-365 days: 11.1%) and lowest among those with two normal hsTnI concentrations (0-30 days: 0.5%, 31-365 days: 2.6%). In neither case did relative hsTnI concentration changes between measurements clearly affect mortality risk. Among persons with a rising hsTnI concentration pattern, 30-day mortality was higher in subjects with a >50% rise compared with those with a less pronounced rise (2.2% vs. <0.1%). Conclusion: Among individuals with suspected ACS, those with a persistently elevated hsTnI concentration consistently had the highest risk of death. In subjects with two normal hsTnI concentrations, mortality was very low and not affected by the magnitude of change between measurements.
KW - Acute coronary syndrome
KW - Biomarkers
KW - Mortality
KW - Myocardial infarction
KW - Troponin-I
UR - http://www.scopus.com/inward/record.url?scp=85189162336&partnerID=8YFLogxK
U2 - 10.1093/eurjpc/zwad373
DO - 10.1093/eurjpc/zwad373
M3 - Journal article
C2 - 38057157
AN - SCOPUS:85189162336
VL - 31
SP - 615
EP - 626
JO - European Journal of Preventive Cardiology
JF - European Journal of Preventive Cardiology
SN - 2047-4873
IS - 5
ER -
ID: 388547245