The Clinical Significance of Elevated Troponin in Patients with Acute Coronary Syndrome with Normal Electrocardiogram

摘要

Background and Objectives The level of cardiac specific troponin (cTn) may be important in patients with acute coronary syndrome (ACS), but with normal electrocardiography (ECG). Subjects and Methods Three hundred and nineteen patients (61±11 years, M:F=212:107), with ACS and normal ECG, who underwent a diagnostic coronary angiogram (CAG), between July 2000 and June 2001, were analyzed according to their cTn level. The clinical characteristics, initial CAG findings and major adverse cardiac events (MACE), during a one-year clinical follow-up, were compared between positive and negative cTn groups. Results Of the enrolled patients, 191 had a negative cTn (group A, 61±10 years, M:F=131:60), and 128 a positive cTn (group B, 60±11 years, M:F=81:47), and 176 (55.2%) were shown to have significant coronary artery stenosis on CAG. There were no significant differences in risk factors between the two groups. The mean left ventricular ejection fraction was 64±9%, and was lower in group B than in group A (59±10% vs. 67±7%, p Conclusion The troponin levels are valuable for the early diagnosis, and prediction of the long-term prognosis, in patients with ACS and a normal ECG.