RT Journal Article
SR Electronic
T1 Troponin T measurement after myocardial infarction can identify left ventricular ejection of less than 40%
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 223
OP 225
DO 10.1136/hrt.80.3.223
VO 80
IS 3
A1 A C R Rao
A1 P O Collinson
A1 R Canepa-Anson
A1 S P Joseph
YR 1998
UL http://heart.bmj.com/content/80/3/223.abstract
AB Aim To 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.Methods Troponin 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.Results There 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.Conclusion Serum 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.