The relative utility of cardiac troponin I, creatine kinase MBmass, and myosin light chain-1 in the long term risk stratification of patients with chest pain.

Graham Scott Hillis, P. Taggart, D. Wardlaw, L. D. Hillis, N. Zhao, W. C. Dalsey, A. Mangione

    Research output: Contribution to journalArticle

    5 Citations (Scopus)

    Abstract

    Background: Sensitive and specific cardiac markers convey important short-term prognostic information about patients with an acute coronary syndrome. There are, however, few data assessing their value as long-term predictors.

    Hypothesis: The aim of the current study was to assess the relative value of three such markers and clinical characteristics in determining the long-term prognosis of patients with chest pain.

    Methods: Cardiac troponin I (cTnI), myosin light chain-1 (MLC-1), and creatine kinase-MBmass levels were obtained on admission (0 h) and at 4, 8, 16, and 24 h in 208 patients with chest pain. Eligible subjects were determined, at the time of hospital admission, to be at >7% risk of acute myocardial infarction (MI), but without new ST-segment elevation on their presenting electrocardiogram. Follow-up was performed a median of 28 (range 1-46) months later. The primary study endpoint was death or nonfatal MI, subsequent to the index admission.

    Results: Cardiac TnI levels greater than or equal to0.2 ng/ml (odds ratio [OR] 1.93, 95% confidence interval [CI] 1.09-3.40) and MLC-1 levels greater than or equal to1 ng/ml (OR 3.24, 95% CI 1.83-5.73) were both significant predictors of death or MI during long-term follow-up; MLC-1 was, however, the only independent biochemical predictor (OR 2.11, 95% CI 1.14-3.93).

    Conclusions: Both cTnI and MLC-1 predict the long-term outcome of patients with chest pain, but, in this cohort, MLC-1 proved to be a better predictor of mortality and nonfatal acute MI.

    Original languageEnglish
    Pages (from-to)147-152
    Number of pages5
    JournalClinical Cardiology
    Volume26
    Publication statusPublished - 2003

    Keywords

    • acute coronary syndrome
    • prognosis
    • myosin light chain-1
    • cardiac troponin I
    • ACUTE MYOCARDIAL-INFARCTION
    • ACUTE CORONARY SYNDROMES
    • UNSTABLE ANGINA
    • ARTERY DISEASE
    • CARDIOVASCULAR PROCEDURES
    • PROGNOSTIC VALUE
    • T LEVELS
    • EMERGENCY
    • MARKERS
    • MANAGEMENT

    Cite this

    Hillis, G. S., Taggart, P., Wardlaw, D., Hillis, L. D., Zhao, N., Dalsey, W. C., & Mangione, A. (2003). The relative utility of cardiac troponin I, creatine kinase MBmass, and myosin light chain-1 in the long term risk stratification of patients with chest pain. Clinical Cardiology, 26, 147-152.