RT Journal Article
SR Electronic
T1 Clinical significance of initial troponin I in the grey zone in emergency department chest pain patients: a retrospective pilot study
JF Emergency Medicine Journal
JO Emerg Med J
FD BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine
SP 302
OP 304
DO 10.1136/emj.2009.077669
VO 27
IS 4
A1 Lee, Hwee Min
A1 Kerr, Debra
A1 O'H Ici, Darach
A1 Kelly, Anne-Maree
YR 2010
UL http://emj.bmj.com/content/27/4/302.abstract
AB 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.