Prognostic impact of troponin > 0.2 μg/ml and < 0.5 μg/m in UA/NSTIMI

Objective

To evaluate the risk of coronary events in patients with troponin levels > 0.2 μg/ml and < 0.5 μg/ml.

Methods

From June 2000 to October 2002 we selected patients with UA/NSTIMI and divided them in two groups as follows: group I, composed of 90 patients with troponin levels between 0.2 and 0.5 μg/ml, measured at the first 24 hours in the hospital; and group II, composed of 98 patients with a troponin level < 0.2 μg/ml. We excluded all patients with a troponin level > 0.5 μg/ml. We analyzed the clinical results while in hospital and after the first 6 months.

Results

There were no differences between the groups with regard to sex, risk factors and anti-ischemic drugs used while in the hospital. However, there were important differences in some aspects as we will show: age, older patients belonged to group I (65.6 ± 12 years) while in group II the patients were 58.9 ± 13 years old (P < 0.0003); invasive treatment, group I was 88.7% × 21.4% in group II (P < 0.002); vessel obstruction, left anterior descending artery in group I was 91% and in group II was 21% (P < 0.001); and right coronary artery, group I was 52% and group II was 4.2% (P < 0.001).

While in hospital there were no significant differences in mortality between the groups, there were much more refractory cardiac events in group I (12.2%) versus group II (1%) (P < 0.001), and left ventricular dysfunction was 10% in group I versus 1% in group II (P < 0.02).

At 6 months, the global mortality was greater in group I (12%) versus 5% in group II (P < 0.02).

Conclusion

Patients with AU/NSTIMI with troponin levels more than 0.2 μg/ml had more risk of death in 6 months.