Cardiac-Specific Troponin I Levels to Predict the Risk of Mortality in Patients with Acute Coronary Syndromes

Antman, Elliott M.; Tanasijevic, Milenko J.; Thompson, Bruce; Schactman, Mark; McCabe, Carolyn H.; Cannon, Christopher P.; Fischer, George A.; Fung, Anthony Y.; Thompson, Christopher; Wybenga, Donald; Braunwald, Eugene

doi:10.1056/nejm199610313351802

Cited by 1,749Acute Myocardial Infarction ResearchCardiac Imaging and DiagnosticsInflammatory Biomarkers in Disease Prognosis

Cardiac-Specific Troponin I Levels to Predict the Risk of Mortality in Patients with Acute Coronary Syndromes

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Antman, Elliott M., Tanasijevic, Milenko J., Thompson, Bruce, Schactman, Mark, McCabe, Carolyn H., Cannon, Christopher P., Fischer, George A., Fung, Anthony Y. +3 more·1996·New England Journal of Medicine

DOI 10.1056/nejm199610313351802

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Abstract

BACKGROUND: In patients with acute coronary syndromes, it is desirable to identify a sensitive serum marker that is closely related to the degree of myocardial damage, provides prognostic information, and can be measured rapidly. We studied the prognostic value of cardiac troponin I levels in patients with unstable angina or non-Q-wave myocardial infarction. METHODS: In a multicenter study, blood specimens from 1404 symptomatic patients were analyzed for cardiac troponin I, a serum marker not detected in the blood of healthy persons. The relation between mortality at 42 days and the level of cardiac troponin I in the specimen obtained on enrollment was determined both before and after adjustment for baseline characteristics. RESULTS: The mortality rate at 42 days was significantly higher in the 573 patients with cardiac troponin I levels of at least 0.4 ng per milliliter (21 deaths, or 3.7 percent) than in the 831 patients with cardiac troponin I levels below 0.4 ng per milliliter (8 deaths, or 1.0 percent; P < 0.001). There were statistically significant increases in mortality with increasing levels of cardiac troponin I (P < 0.001). Each increase of 1 ng per milliliter in the cardiac troponin I level was associated with a significant increase (P = 0.03) in the risk ratio for death after adjustment for the base-line characteristics that were independently predictive of mortality (ST-segment depression and age > or = 65 years). CONCLUSIONS: In patients with acute coronary syndromes, cardiac troponin I levels provide useful prognostic information and permit the early identification of patients with an increased risk of death.

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Cardiac troponin I (cTnI) is a gold-standard biomarker for cardiovascular diseases.
“Cardiac troponin I (cTnI) is a gold-standard biomarker for cardiovascular diseases (the leading cause of death worldwide)22–25.”
From Nanoproteomics enables proteoform-resolved analysis of low-abundance proteins in human serum (2020) · cites this paper as [24]

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Authors: Antman, E. M., Tanasijevic, M. J., Thompson, B., Schactman, M., McCabe, C. H., Cannon, C. P., Fischer, G. A., Fung, A. Y., Thompson, C., Wybenga, D., & Braunwald, E.
Affiliations: Brigham and Women's Hospital (US)
Maryland Medical Research Institute (US)
University of British Columbia (CA)
ORCID: Antman, Elliott M.
Cannon, Christopher P.
Fung, Anthony Y.
Thompson, Christopher
Venue: New England Journal of Medicine
Publisher: Massachusetts Medical Society
Published: 1996-10-31
Volume: 335
Issue: 18
Pages: 1342-1349
ISSN: 0028-4793 (ISSN-L)
1533-4406
DOI: 10.1056/nejm199610313351802
OpenAlex: W2327567334
Cited by: 1,749
References: 35
Citations by year: 2026: 10 · 2025: 15 · 2024: 18 · 2023: 18 · 2022: 19 · 2021: 24 · 2020: 23 · 2019: 34 · 2018: 26 · 2017: 32 · 2016: 40 · 2015: 51 · 2014: 55 · 2013: 56 · 2012: 58
FWCI: 69.44
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: New England Journal of Medicine (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (5r01hl042311-03, 5r01hl042428-04)
National Heart, Lung, and Blood Institute (R01-HL42311, R01-HL-42428)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
Health Sciences › Medicine › Oncology › Inflammatory Biomarkers in Disease Prognosis
Keywords: cardiac troponin I, acute coronary syndrome, mortality prediction, prognostic factors, unstable angina, non-Q-wave myocardial infarction, myocardial injury, ST-segment depression, risk stratification
MeSH terms: Acute Disease, Adult, Aged, Angina, Unstable, Creatine Kinase, Female, Humans, Isoenzymes, Male, Middle Aged, Myocardial Infarction, Prognosis, Retrospective Studies, Risk, Biomarkers, Multivariate Analysis, Odds Ratio, Troponin I

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Cardiac-Specific Troponin I Levels to Predict the Risk of Mortality in Patients with Acute Coronary Syndromes

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