Coronary Artery DiseaseIncremental prognostic value of serum levels of troponin T and C-reactive protein on admission in patients with unstable angina pectoris☆
Section snippets
Patient population
The study population consisted of 102 consecutive patients (73 men and 29 women, aged 30 to 75 years [mean 64 ± 9 years]) hospitalized with Braunwald class IIIB unstable angina over a period of 12 months in 4 Italian hospitals (Table I). The mean time between the last anginal episode and hospitalization was 11 ± 7 hours (range 1 to 48). We excluded patients aged >75 years, patients with other cardiac diseases, those with an ejection fraction <40%,1 and those with inflammatory or neoplastic
Results
A total of 15 patients developed myocardial infarction, 12 during hospitalization and 3 during the 3-month follow-up period (1 of whom died) (Table II). There was no difference in the incidence of myocardial infarction between university and peripheral hospitals (5 of 39 vs 10 of 63; p = NS). Ten of 63 patients in the 3 district hospitals, and all 39 patients in the university hospital underwent coronary angiography: 2 had no critical stenoses, 21 had 1-vessel disease, and 26 had multivessel
Discussion
The conflicting results observed with several indicators of prognosis in patients with unstable angina can be explained by the inclusion of patients with a different severity of angina, by the inclusion of non–Q-wave myocardial infarction, by the different periods of admission from symptom onset, and with different end points considered.
In clinical practice, however, prognosis of individual patients is based on synthesis of several indicators such as clinical history, objective findings,
Acknowledgements
We wish to thank Frank Dini, MD, and Daniele Bernardi, MD, of the General Hospital in Barga, Gabriele Giorgi, MD, of the General Hospital in Frascati, and Nadia Aspromonte, MD, and Maria Antonietta Pala, MD, of the Santo Spirito Hospital in Rome for their participation. We are also indebted to the nurses of the coronary care unit at Policlinico Gemelli for their assistance, and to Vanessa Perrin and Lucia De Angelis for their assistance in the preparation of the manuscript.
References (18)
- et al.
Unstable anginanatural history and determinant of prognosis
Am J Cardiol
(1981) - et al.
Unstable anginaoutcome according to clinical presentation
J Am Coll Cardiol
(1992) - et al.
Prognostic value of cardiac TT in unstable angina pectoris
Am J Cardiol
(1995) - et al.
Relation of severity of symptoms to transient myocardial ischemia and prognosis in unstable angina
J Am Coll Cardiol
(1995) - et al.
Prognostic significance of silent myocardial ischemia in patients with unstable angina
J Am Coll Cardiol
(1987) - et al.
Usefulness of the addition of heart rate variability to Holter monitoring in predicting in-hospital cardiac events in patients with unstable angina pectoris
Am J Cardiol
(1997) - et al.
Ruling out myocardial infarction
N Engl J Med
(1991) - et al.
Development and in vitro characterization of a new immunoassay of cardiac TT
Clin Chem
(1992) - et al.
S-Troponin T in suspected ischemic myocardial injury compared with mass and catalytic concentrations of S-creatine kinase isoenzyme MB
Clin Chem
(1991)
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This study was supported in part by Grant 94.00518.PF41 from the Italian National Research Council, targeted project “Prevention and Control Disease Factors,” Rome, Italy, by Grant PL951505 from the European Community BIOMED 2 Programme, and by Associazione Ricerche Coronariche, Catholic University, Rome, Italy. Manuscript received December 8, 1997; revised manuscript received and accepted May 6, 1998.