hsTnT Levels Predict Adverse Cardiac Events
Individuals with multiple measurements of hsTnT levels at 19 ng/L or lower have a less than 1% risk for 30-day risk for adverse cardiac events (ACE), according to a recent study.
In their prospective, observational study, the researchers enrolled 1690 individuals who presented at 15 emergency departments with suspected acute coronary syndrome and 1301 healthy individuals.
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The researchers collected serial blood samples at baseline and at 3 hours, 6 to 9 hours, and 12 to 24 hours after presentation. The samples were assessed using the recently approved troponin assay. ACE included myocardial infarction (MI), urgent revascularization, and death.
Using the data from the healthy participants’ samples, the researchers defined the upper reference level for hsTnT as 19 ng/L.
The researchers found that a single hsTnT level below 6 ng/L at baseline had a negative predictive value for acute MI of 99.4% among 1600 participants with suspected acute coronary syndrome. Additionally, hsTnT levels of 19 ng/L or less at baseline and 3 hours post-presentation had a negative predictive value of 99.3% for 30-day adverse cardiac event.
“Identifying a low-risk cohort may permit early emergency department discharge and avoid unnecessary hospitalization,” the researchers concluded.
“A single hsTnT level less than 6 ng/L was associated with a markedly decreased risk of [acute MI], while serial levels at 19 ng/L or less identified patients at less than 1% risk of 30-day ACE.”
—Melissa Weiss
Reference:
Peacock WF, Baumann BM, Bruton D, et al. Efficacy of high-sensitivity troponin T in identifying very-low-risk patients with possible acute coronary syndrome [published online December 13, 2017]. JAMA Cardiol. doi:10.1001/jamacardio.2017.4625.