Cardiac troponins in suspected acute coronary syndrome - A meta-analysis of published trials

We performed a meta-analysis of published trials to determine the predictiv e value of cardiac troponin (cTnl) and T (cTnT) levels for adverse events ( death and myocardial infarction) in acute coronary syndrome without ST elev ation (ACS), The accumulated odds ratio (OR) for adverse events (30 days) i n ACS with elevated cTnl (n = 5,759) and cTnT (n = 5,483) was 4.9 (95% conf idence interval, CI, 3.9-6.2) and 4.6 (95% CI 3.8-5.5), respectively. Trial s that mandated timed serum sampling (6 or more hours after symptom onset) had an improved predictive value for elevated cTnl (n = 2,807, OR 8.8; 95% CI 5.9-13.2) and cTnT(n = 1,990, OR 8.5; 95% CI 5.9-12.5). In conclusion, c Tnl and cTnT provide similar information in ACS, The risk of adverse events is 4-fold higher in patients with suspected ACS and elevated serum cTn. Fo r patients with an elevated timed (g-hour) sample the risk is over 8-fold h igher. Copyright (C) 2001 S. Karger AG. Basel.