High sensitivity cardiac troponin T in patients not having an acute coronary syndrome: results from the TRAPID-AMI study

Richard M. Nowak, Henry Ford Health
Christian Mueller
Evangelos Giannitsis
Michael Christ
Jordi Ordonez-Llanos
Christopher DeFilippi
James McCord, Henry Ford Health
Richard Body
Mauro Panteghini
Tomas Jernberg
Mario Plebani
Franck Verschuren
John K. French
Robert Christenson
Gordon Jacobsen, Henry Ford Health
Carina Dinkel
Bertil Lindahl

Abstract

PURPOSE: To describe the baseline, 1 hr and delta high sensitivity cardiac troponin (hs-cTnT) values in patients with suspected acute myocardial infarction (AMI) but without a final acute coronary syndrome (ACS) diagnosis.

MATERIALS AND METHODS: hs-cTnT assay for RAPID rule out of acute myocardial infarction (TRAPID-AMI) was a prospective diagnostic trial that enrolled emergency department (ED) patients with suspected AMI. Final patient diagnoses were adjudicated by a clinical events committee and subjects placed in different clinical groups: AMI, unstable angina, non-ACS cardiac, non-cardiac and unknown origin. The baseline, 1 hr and delta hs-cTnT values were analysed in the 902 non-ACS patients.

RESULTS: Amongst the 1282 studied the patient groups were 213 (17%) AMI, 167 (13%) unstable angina, 113 (9%) non-ACS cardiac, 288 (22%) non-cardiac and 501 (39%) unknown origin. The hs-cTnT values in the non-cardiac and unknown origin groups were combined. The median hs-cTnT values (ng/L) were higher (p < 0.001) in the non-ACS cardiac compared to the non-cardiac/unknown origin group at baseline (11.8,

CONCLUSIONS: Hs-cTnT may help predict whether non-ACS ED patients have a final non-ACS cardiac or non-cardiac/unknown origin diagnoses.