Studies reporting incidence of myocardial infarction classified according to the universal definition
Diagnostic classification (%) proportion of all patients with elevation in baseline cardiac troponin | ||||||||
---|---|---|---|---|---|---|---|---|
Population | Troponin assay and upper reference limit* | Number with elevated cardiac troponin concentrations (% of total study population) | Myocardial injury (%) | Type 1 MI (%) | Type 2 MI (%) | Type 3/4/5 MI (%) | Unclassified | |
Javed et al31 | Unselected hospital inpatients with cTnI measured (n=2979)† | cTnI (>40 ng/L) ADVIA immunoassay (Siemens) | 701 (23.5%) | 461 (65.8%) | 143 (20.4%) | 64 (9.1%) | 9 (1.3%) | 24 (3.4%) |
El-Haddad et al32 | Unselected hospital inpatients with cTnI measured (n=807) | cTnI (>160 ng/L) Beckman Access | 807 (100%) | Not reported | 512 (63.4%) | 295 (36.6%) | Nil | Nil |
Saaby et al33 | Unselected hospital inpatients with cTnI measured (n=4499) | cTnI (>30 ng/L) Architect-STAT (Abbott Diagnostics) | 1961 (43.6%) | 1408 (71.8%) | 397 (20.2%) | 144 (7.3%) | 12 (0.7%) | Nil |
Shah et al6 | Unselected hospital inpatients with cTnI measured (n=2165) | cTnI (>50 ng/L) Architect-STAT (Abbott Diagnostics) | 2165 (100%) | 522 (24.1%) | 1171 (54%) | 429 (19.9%) | 43 (2%) | Nil |
White et al4 | Cardiology inpatients with ACS (2000–2006) (n=2201) | cTnI, cTnT, CK, CK-MB | 169 (7.7%) | Not reported | 106 (62.7%) | 7 (4.1%) | 56 (33.2%) | Nil |
Szymanski et al34 | Cardiology inpatients with ACS (n=2882) | cTn (not specified) | 2882 (100%) | Not reported | 2824 (98%) | 58 (2%) | Nil | Nil |
Stein et al35 | Cardiology and ICU inpatients with ACS (n=2818) | Not reported | 2818 (100%) | Not reported | 2691 (95.5%) | 127 (4.5%) | Nil | Nil |
Baron et al30 | Hospital inpatients with ACS (n=19 763) | Not reported | 19 763 (100%) | Not reported | 17 488 (88.5%) | 1403 (7.1%) | 141 (0.7%) | 731 (3.7%) |
Melberg et al36 | Hospital inpatients with ACS (n=1093) | cTnT (>30 ng/L) Roche Elecsys | 1093 (100%) | Not reported | 967 (88.5%) | 17 (1.6%) | 109 (9.9%) | Nil |
Morrow et al2 | Clinical trial patients with ACS (n=13 608) | Not reported | 1218 (8.9%) | Not reported | 397 (32.6%) | 43 (3.5%) | 778 (63.9%) | Nil |
Sandoval et al37 | Emergency department patients with cTnI measured (n=1112) | cTnI (>34 ng/L) OCD Vitros | 256 (23%) | Not reported | 66 (25.8%) | 190 (74.2%) | Nil | Nil |
Smith et al38 | Emergency department patients with cTnI measured (n=662) | cTnI (>90 ng/L) Siemens Stratus | 139 (20.9%) | Not reported | 40 (28.8%) | 99 (71.2%) | Nil | Nil |
Smith et al39 | Emergency department patients with suspected ACS (n=1096) | cTn (not specified) | 134 (12.2%) | Not reported | 127 (95%) | 7 (5%) | Nil | Nil |
Bonaca et al40 | Emergency department presentations with suspected ACS (n=381) | cTnI (>100 ng/L) Siemens Centaur | 96 (25.2%) | Not reported | 86 (90%) | 10 (10%) | Nil | Nil |
Shah et al8 | Unselected patients with suspected ACS (n=1126) | hs-TnI (F >16 g/L; M >34 ng/L) Architect-STAT high-sensitivity (Abbott Diagnostics) | 338 (30%) | 40 (11.8%) | 242 (71.6%) | 56 (16.6%) | Nil | Nil |
*All units are standardised to ng/L.
†Twenty-seven exclusions (missing data).
ACS, acute coronary syndrome; CK, creatine kinase; cTnI, cardiac troponin I; cTnT, cardiac troponin T; MI, myocardial infarction.