Evaluation and risk stratification of acute coronary syndromes using a low cut-off level of cardiac troponin T, combined with CK-MB mass determination

Objectives: To study the usefulness of combined cardiac Troponin T (cTnT) and CK-MB mass determinations in risk stratification of acute coronary syndromes. Design and methods: Blood samples for cTnT and CK-MB mass were collected at arrival and 4, 8, and 12–24 later in 301 consecutive patients with recent acute chest pain (ACP). Data were also collected for cardiac events. Results: Combined cardiac mortality/nonfatal myocardial infarction over a period of 15 months was lowest in patients with <0.04 μg/l cTnT and -<5.0 μg/l CK-MB mass intermediate in those with elevated cTnT but normal CK-MB mass and highest when both markers were elevated, in absence of early reperfusion. Conclusion:The use of a low cut-off point of cTnT, combined wit CK-MB mass determination, offers a good strategy for risk stratification of ACP patients.