© 2002 by Heart
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Ischaemic heart disease
Troponins to guide the use of invasive treatment in ACS 
Comparing conservative to invasive treatment in patients with acute coronary syndromes (ACS) treated with tirofiban, early invasive treatment showed an 18% reduction in death/myocardial infarction (MI)/repeat ACS within six months. A total of 2220 patients with ACS were enrolled and 1780 completed the six month follow up with cardiac troponin-I (cTnI) available. Patients with a cTnI concentration of > 0.1 ng/ml experienced a significant reduction in the primary end point with the invasive versus conservative strategy (15.3% v 25.0%; odds ratio (OR) 0.54, 95% confidence interval (CI) 0.40 to 0.73). Patients with cTnI concentrations of < 0.1 ng/ml had no benefit from early invasive management (16.0% v 12.4%; OR 1.4, 95% CI 0.89 to 2.05, p < 0.001 for interaction). Similar results were observed with cTnT.
Morrow DA, Cannon CP, Rifai N, Frey MJ, Vicari R, Lakkis N, Robertson
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