Heart 1998;80:223-225 ( September )

Troponin T measurement after myocardial infarction can identify left ventricular ejection of less than 40%

A C R Rao,^a P O Collinson,^b R Canepa-Anson,^a S P Joseph^a

^a Department of Cardiology, Mayday University Hospital, Mayday Road, Croydon, Surrey CR7 7YE, UK, ^b Department of Chemical Pathology, Mayday University Hospital

Correspondence to: Dr Joseph.

Accepted for publication 24 November 1997

AimTo determine whether measurement of serum troponin T concentration after first acute myocardial infarction can be used to identify patients with a left ventricular ejection fraction of < 40%, who have an adverse prognosis.
MethodsTroponin T concentration was measured, and coronary and left ventriculography performed in 50 consecutive patients with acute myocardial infarction. Angiographic left ventricular ejection fraction was compared with serum troponin T concentration. Patients with previous myocardial infarction were excluded.
ResultsThere was a strong negative correlation between left ventricular ejection fraction and troponin T concentration. Spearman's rank correlation coefficient (corrected for ties) was 0.72 (95% confidence intervals (CI) 0.55 to 0.83; p < 0.0001). Analysis by receiver operator characteristic curve produced an area under the curve of 0.9773 (95% CI 0.9409 to 1.0136). A troponin T concentration of > 2.8 µg/l predicted a left ventricular ejection fraction of < 40% with a sensitivity of 100% (CI 84.6 to 100.0) and specificity of 92.9% (CI 76.5 to 99.1). Exclusion of patients who did not receive thrombolytic treatment did not significantly affect the results.
ConclusionSerum troponin T concentration measured 12-48 hours after admission for first myocardial infarction is a reliable, simple, quick, inexpensive, non-invasive method for identifying patients with a left ventricular ejection fraction of < 40% for whom there is a poor prognosis.

Keywords: troponin T;  acute myocardial infarction;  angiotensin converting enzyme inhibitors;  left ventricular function

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© 1998 by Heart
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