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Clinical and prognostic implications of high-sensitivity cardiac troponin T concentrations in type 2 non-ST elevation

K M Eggers1, T Baron1, A Gard1

  • 1Department of Medical Sciences, Uppsala University, Uppsala, Sweden.

International Journal of Cardiology. Heart & Vasculature
|February 24, 2022
PubMed

Insights

High-sensitivity cardiac troponin (hs-cTnT) levels independently predict adverse outcomes in type 2 myocardial infarction (MI). These findings in type 2 MI are similar to type 1 MI, highlighting diagnostic challenges.

Area of Science:

  • Cardiology
  • Biomarkers
  • Clinical Medicine

Background:

  • Limited evidence exists on cardiac troponin in type 2 myocardial infarction (MI).
  • High-sensitivity cardiac troponin (hs-cTnT) is crucial in type 1 MI.
  • This study investigates hs-cTnT in type 2 MI.

Purpose of the Study:

  • To assess clinical and prognostic implications of hs-cTnT in type 2 MI.
  • To compare hs-cTnT findings in type 2 MI with type 1 MI.
  • To evaluate hs-cTnT's predictive value for mortality and adverse events.

Main Methods:

  • Retrospective registry-based cohort study (SWEDEHEART).
  • Included 4607 patients with type 2 MI and 43,405 with type 1 MI (excluding STEMI).
  • Multivariable-adjusted regressions analyzed hs-cTnT associations with outcomes over 1.9 years.

Main Results:

  • Hs-cTnT associated with risk factors/comorbidities in type 2 NSTEMI, similar to type 1 NSTEMI.
  • Hs-cTnT independently predicted all-cause mortality and MACE in type 2 NSTEMI.
  • Prognostic association of hs-cTnT was stronger in type 2 NSTEMI patients without prior cardiovascular disease.

Conclusions:

  • Hs-cTnT concentrations independently predict adverse outcomes in type 2 NSTEMI.
  • Similarities between type 1 and type 2 NSTEMI hs-cTnT findings are notable.
  • These similarities underscore the diagnostic challenges in differentiating MI types.
Abstract

Keywords:
CAD, Coronary artery diseaseCVD, Cardiovascular diseaseHigh-sensitivity cardiac troponin TICD-10-CM, International Classification of Diseases, 10th revision, Clinical ModificationMAE, Major adverse eventsMI, Myocardial infarctionNSTEMI, Non-ST elevation myocardial infarctionRisk predictionSWEDEHEART, Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended TherapiesTOTAL-AMI, Tailoring Of Treatment in All comers with Acute Myocardial InfarctionType 2 myocardial infarctioncTn, Cardiac troponinhs-cTnT, High-sensitivity cardiac troponin T

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