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

We performed a meta-analysis of published trials to determine the predictive value of cardiac troponin (cTnl) and T (cTnT) levels for adverse events (death and myocardial infarction) in acute coronary syndrome without ST elevation (ACS), The accumulated odds ratio (OR) for adverse events (30 days) in ACS with elevated cTnl (n = 5,759) and cTnT (n = 5,483) was 4.9 (95% confidence interval, CI, 3.9-6.2) and 4.6 (95% CI 3.8-5.5), respectively. Trials 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, cTnl 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. For patients with an elevated timed (g-hour) sample the risk is over 8-fold higher. Copyright (C) 2001 S. Karger AG. Basel.