[Predictive value of positive troponin I in clinical prognosis of non-ST-segment elevation acute coronary syndrome]

Abstract

Objective: To investigate the predictive value of positive troponin I (TnI) on early prognosis in patients with non-ST-segment elevation acute coronary syndrome (NSTE ACS), and to evaluate TnI as a predictor of risk for the combined end points of cardiac events in NSTE ACS.

Methods: 545 patients with non-ST-elevation acute coronary syndrome were double-blind randomly enrolled in two groups of study, receiving invasive or noninvasive treatment, respectively. At admission, all patients' baseline levels of TnI and CK-MB were determined and related to outcome at 30th day and 6th month of follow-up. Aspirin, beta-blocker, ACEI and LWMH were given depending on patients' clinical condition.

Results: After a follow up of 6 months, hospitalization because of recurrent angina pectoris and combined end points of cardiac events in TnI positive patients occurred much more as compared with that in the TnI negative patients and the prognosis improved with early invasive interventional treatment strategy in the TnI positive patients (P < 0.01) at 30th day and 6th month. For TnI negative patients, there was no difference between the two groups whether invasive or non-invasive therapy was given.

Conclusions: There is high recurrence rate of angina pectoris and increased number of combined end points of cardiac events in positive TnI patients during follow-up period. TnI served as an important risk factor in NSTE ACS patients and active early invasive intervention therapy should be the first choice for TnI positive patients, but it makes no more benefits for TnI negative patients.