Skip to main content
Journal cover image

Comparison of cardiac troponin T versus creatine kinase-MB for risk stratification in a chest pain evaluation unit.

Publication ,  Journal Article
Newby, LK; Kaplan, AL; Granger, BB; Sedor, F; Califf, RM; Ohman, EM
Published in: Am J Cardiol
April 1, 2000

We evaluated cardiac troponin T (cTnT) and creatine kinase-MB (CK-MB) for risk stratification of chest pain unit (CPU) patients. We studied 383 consecutive patients with chest pain assigned to our CPU by emergency department physicians. At baseline all had normal or nondiagnostic electrocardiograms, no high-risk clinical features, and negative CK/CK-MB. CK-MB and electrocardiograms were taken at 0, 4, 8, and 12 hours and cTnT at 0, 4, and 8 hours. Eight patients (2.1%) were CK-MB positive and 39 (10.2%) were cTnT positive, including all but 1 CK-MB-positive patient. All marker-positive patients were detected by 8 hours. Seven cTnT-positive patients and 1 cTnT-negative patient had myocardial infarction (p <0.0001). cTnT-positive patients were older, less likely to be women or smokers, and more often had diabetes mellitus or known coronary disease (CAD). Seventy-one percent of patients underwent diagnostic testing. cTnT-positive patients more often underwent angiography (46% vs 20%) and underwent stress testing less often (28% vs 57%) than cTnT-negative patients. When performed, their stress tests were more often positive (46% vs 14%) and they more often had angiographically significant lesions (89% vs 49%) and multivessel disease (67% vs 29%). There were no short-term deaths. Long-term mortality was higher in cTnT-positive patients (27% vs 7%, p <0.0001). Thus, cTnT identified more CPU patients with myocardial necrosis and multivessel CAD than CK-MB and a population with high long-term mortality risk. Routine use of cTnT in CPUs could facilitate risk stratification and management.

Duke Scholars

Published In

Am J Cardiol

DOI

ISSN

0002-9149

Publication Date

April 1, 2000

Volume

85

Issue

7

Start / End Page

801 / 805

Location

United States

Related Subject Headings

  • Troponin T
  • Risk Assessment
  • Retrospective Studies
  • Prognosis
  • Myocardium
  • Middle Aged
  • Male
  • Isoenzymes
  • Humans
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Newby, L. K., Kaplan, A. L., Granger, B. B., Sedor, F., Califf, R. M., & Ohman, E. M. (2000). Comparison of cardiac troponin T versus creatine kinase-MB for risk stratification in a chest pain evaluation unit. Am J Cardiol, 85(7), 801–805. https://doi.org/10.1016/s0002-9149(99)00870-x
Newby, L. K., A. L. Kaplan, B. B. Granger, F. Sedor, R. M. Califf, and E. M. Ohman. “Comparison of cardiac troponin T versus creatine kinase-MB for risk stratification in a chest pain evaluation unit.Am J Cardiol 85, no. 7 (April 1, 2000): 801–5. https://doi.org/10.1016/s0002-9149(99)00870-x.
Newby LK, Kaplan AL, Granger BB, Sedor F, Califf RM, Ohman EM. Comparison of cardiac troponin T versus creatine kinase-MB for risk stratification in a chest pain evaluation unit. Am J Cardiol. 2000 Apr 1;85(7):801–5.
Newby, L. K., et al. “Comparison of cardiac troponin T versus creatine kinase-MB for risk stratification in a chest pain evaluation unit.Am J Cardiol, vol. 85, no. 7, Apr. 2000, pp. 801–05. Pubmed, doi:10.1016/s0002-9149(99)00870-x.
Newby LK, Kaplan AL, Granger BB, Sedor F, Califf RM, Ohman EM. Comparison of cardiac troponin T versus creatine kinase-MB for risk stratification in a chest pain evaluation unit. Am J Cardiol. 2000 Apr 1;85(7):801–805.
Journal cover image

Published In

Am J Cardiol

DOI

ISSN

0002-9149

Publication Date

April 1, 2000

Volume

85

Issue

7

Start / End Page

801 / 805

Location

United States

Related Subject Headings

  • Troponin T
  • Risk Assessment
  • Retrospective Studies
  • Prognosis
  • Myocardium
  • Middle Aged
  • Male
  • Isoenzymes
  • Humans
  • Female