We have located links that may give you full text access.
Myoglobin and troponin I elevation predict 5-year mortality in patients with undifferentiated chest pain in the emergency department.
American Heart Journal 2008 November
BACKGROUND: The long-term prognostic significance of elevated cardiac markers in an undifferentiated patient population with chest pain is unknown.
METHODS: Serum troponin I (cTnI), creatine kinase-MB (CK-MB), and myoglobin were measured at presentation in 951 consecutive patients evaluated in the emergency department for possible acute coronary syndrome, and all-cause mortality was measured over 5 years.
RESULTS: Final diagnoses included myocardial infarction in 70 (7.4%), unstable angina in 78 (8.2%), stable angina in 26 (2.7%), heart failure in 135 (14.2%), syncope in 61 (6.4%), arrhythmia in 62 (6.5%), and noncardiac diagnoses in 519 (54.6%). Our study population had a mean (+/-SD) age of 63 (+/-16), 434 (46%) were male, 774 (81%) were African American, 408 (43%) had known coronary artery disease, 647 (68%) had hypertension, 244 (26%) had diabetes mellitus, and 237 (25%) had a serum creatinine>or=1.5 mg/dL. At 5 years, there were 349 (36.7%) deaths. In a multivariate model with adjustment for baseline covariates, an elevated cTnI>or=1.0 ng/mL (hazard ratio [HR] 1.7, 95% CI 1.3-2.3) and myoglobin>or=200 ng/mL (HR 1.6, 95% CI 1.2-2.1), but not CK-MB>or=9.0 ng/mL (HR 0.9, 95% CI 0.6-1.3), remained independent predictors of all-cause mortality. Patients with both elevated cTnI and myoglobin had a particularly high mortality rate.
CONCLUSION: Among patients evaluated in the emergency department for possible acute coronary syndromes, myoglobin and cTnI at presentation are powerful, independent predictors of long-term (5-year) prognosis.
METHODS: Serum troponin I (cTnI), creatine kinase-MB (CK-MB), and myoglobin were measured at presentation in 951 consecutive patients evaluated in the emergency department for possible acute coronary syndrome, and all-cause mortality was measured over 5 years.
RESULTS: Final diagnoses included myocardial infarction in 70 (7.4%), unstable angina in 78 (8.2%), stable angina in 26 (2.7%), heart failure in 135 (14.2%), syncope in 61 (6.4%), arrhythmia in 62 (6.5%), and noncardiac diagnoses in 519 (54.6%). Our study population had a mean (+/-SD) age of 63 (+/-16), 434 (46%) were male, 774 (81%) were African American, 408 (43%) had known coronary artery disease, 647 (68%) had hypertension, 244 (26%) had diabetes mellitus, and 237 (25%) had a serum creatinine>or=1.5 mg/dL. At 5 years, there were 349 (36.7%) deaths. In a multivariate model with adjustment for baseline covariates, an elevated cTnI>or=1.0 ng/mL (hazard ratio [HR] 1.7, 95% CI 1.3-2.3) and myoglobin>or=200 ng/mL (HR 1.6, 95% CI 1.2-2.1), but not CK-MB>or=9.0 ng/mL (HR 0.9, 95% CI 0.6-1.3), remained independent predictors of all-cause mortality. Patients with both elevated cTnI and myoglobin had a particularly high mortality rate.
CONCLUSION: Among patients evaluated in the emergency department for possible acute coronary syndromes, myoglobin and cTnI at presentation are powerful, independent predictors of long-term (5-year) prognosis.
Full text links
Related Resources
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app