American Heart Journal
Volume 148, Issue 5 , Pages 739-742 , November 2004

Evidence-based decision limits for cardiac troponin: Low-level elevation and prognosis

  • David A. Morrow, MD, MPH

      Affiliations

    • TIMI Study Group and Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, Mass, USA
    • Corresponding Author InformationReprint requests: David A. Morrow, MD, MPH, Cardiovascular Division, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.

References 

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  2. Braunwald E, Antman EM, Beasley JW, et al.  ACC/AHA 2002 guideline update for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction (summary article). J Am Coll Cardiol. 2002;40:1366–1374
  3. Jaffe AS, Ravkilde J, Roberts R, et al.  It's time for a change to a troponin standard. Circulation. 2000;102:1216–1220
  4. Heidenreich PA, Alloggiamento T, Melsop K, et al.  The prognostic value of troponin in patients with non-ST elevation acute coronary syndromes (a meta-analysis). J Am Coll Cardiol. 2001;38:478–485
  5. Apple FS, Quist HE, Doyle PJ, et al.  Plasma 99th percentile reference limits for cardiac troponin and creatine kinase MB mass for use with ESC/ACC consensus recommendations. Clin Chem. 2003;49:1331–1336
  6. Pham M. Prognostic value of low-level troponin-I elevation in patients without definite acute coronary syndromes. Am Heart J 2004;148:776–82
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  8. Morrow DA. Troponins in patients with acute coronary syndromes (biologic, diagnostic, and therapeutic implications). Cardiovasc Toxicol. 2001;1:105–110
  9. Morrow DA, Cannon CP, Rifai N, et al.  Ability of minor elevations of troponin I and T to identify patients with unstable angina and non-ST elevation myocardial infarction who benefit from an early invasive strategy (results from a prospective, randomized trial). JAMA. 2001;286:2405–2412
  10. Kontos MC, Shah R, Fritz LM, et al. Implication of different cardiac troponin I levels for clinical outcomes and prognosis of acute chest pain patients. J Am College Cardiol 2004;43:958–65
  11. Meier MA, Al-Badr WH, Cooper JV, et al.  The new definition of myocardial infarction (diagnostic and prognostic implications in patients with acute coronary syndromes). Arch Intern Med. 2002;162:1585–1589
  12. Trevelyan J, Needham EW, Smith SC, et al.  Sources of diagnostic inaccuracy of conventional versus new diagnostic criteria for myocardial infarction in an unselected UK population with suspected cardiac chest pain, and investigation of independent prognostic variables. Heart. 2003;89:1406–1410
  13. Pell JP, Simpson E, Rodger JC, et al.  Impact of changing diagnostic criteria on incidence, management, and outcome of acute myocardial infarction (retrospective cohort study). BMJ. 2003;326:134–135
  14. Venge P, Lagerqvist B, Diderholm E, et al.  Clinical performance of three cardiac troponin assays in patients with unstable coronary artery disease (a FRISC II substudy). Am J Cardiol. 2002;89:1035–1041
  15. Morrow DA, Rifai N, Sabatine MS, et al.  Evaluation of the AccuTnI cardiac troponin I assay for risk assessment in acute coronary syndromes. Clin Chem. 2003;49:1396–1398
  16. Wright SA, Sawyer DB, Sacks DB, et al.  Elevation of troponin I levels in patients without evidence of myocardial injury. JAMA. 1997;278:2144
  17. Jaffe AS. Elevations in cardiac troponin measurements (false false positives). Cardiovasc Toxicol. 2001;1:87–92
  18. Goldhaber SZ. Cardiac biomarkers in pulmonary embolism. Chest. 2003;123:1782–1784

PII: S0002-8703(04)00289-3

doi: 10.1016/j.ahj.2004.05.024

American Heart Journal
Volume 148, Issue 5 , Pages 739-742 , November 2004

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