Clinical significance of initial troponin I in the grey zone in emergency department chest pain patients: a retrospective pilot study. Issue 4 (12th April 2010)

• Record Type: Journal Article
• Authors: Lee, Hwee Min; Kerr, Debra; O'H Ici, Darach; Kelly, Anne-Maree
• Is Part Of: Emergency medicine journal. Volume 27:Issue 4(2010)
• Page Start: 302
• Page End: 304
• Publication Date: 2010-04-12
• Subjects: Acute coronary syndrome -- cardiac care -- chest pain -- diagnosis -- troponin; Emergency medicine -- Periodicals; 616.02505
• DOI: 10.1136/emj.2009.077669
• Languages: English
• ISSNs: 1472-0205

Abstract

Abstract : Aim: 'Normal' range for cardiac troponin I (TnI) has changed with more sensitive tests, but the validity of low-level elevations is contentious. We aimed to describe the characteristics and outcome of patients with an initial TnI level 1–5 times the upper limit of normal. Methods: Retrospective study of patients assessed for ACS with initial TnI level between 0.05–0.19 ng/ml. Data collected included demographics, clinical data, TnI levels and outcome. Primary outcome was the proportion of patients who had a serial TnI rise consistent with ACS. Results: 72 patients were studied; median age 71, median TIMI score 3, 66.7% male. 35 patients (48.6%) had a TnI rise consistent with ACS. Conclusion: Approximately half of patients with initial TnI between 0.05–0.19ng/ml had a TnI rise consistent with ACS. An initial TnI in this range is not, of itself, indicative of ACS. Clinical decision-making should be guided by clinical features and serial TnI measurement.