Cardiac troponin I measurement using the ACS:180 to predict four-year cardiac event rate

Ann Clin Biochem 2008;45:184-188
© 2008 Association for Clinical Biochemistry


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Original Article

Paul O Collinson ,
Gloria H Gaynor and
David C Gaze

Department of Chemical Pathology, 2nd Floor Jenner Wing, St Geroge’s Hospital and Medical School, Blackshaw Road, London SW17 0QT, UK

Corresponding author: Dr Paul O Collinson. Email: paul.collinson{at}

Background: This study aimed at evaluating the ability of cardiac troponinI (cTnI) measurement on the ACS:180 for prognostic risk stratification.Sequential admissions to the coronary care unit of a busy districtgeneral hospital were studied. All patients were followed upfor a maximum of 4.3 years and cardiac events, either cardiacdeath, readmission with acute myocardial infarction or admissionwith acute unstable angina were documented.

Methods: Blood samples were taken on admission and at 4 and 12 h. A serum aliquot was taken and stored frozen at –70oC. The frozenaliquots were subsequently analysed for cTnI by chemiluminescentimmunoassay using an ACS:180. Patients were categorized intothose with or without ST segment elevation on the presentingelectrocardiogram. The optimized decision threshold for mortalityand event prediction was then determined by log-rank analysisand by construction of Kaplan-Meier survival plots.

Results: A total of 289 patients (196 men) median age 65.3 years, range27.4–87.9 years were studied. Out of this, 139 had STelevation myocardial infarction (STEMI) and 150 had suspectednon-STEMI (NSTEMI). Full data were available from 278 patients.Admission cTnI did not predict any of the endpoints in the STEMIgroup. In patients admitted with suspected NSTEMI, admissionand peak cTnI predicted increased risk of death or readmissionwith acute myocardial infarction. In addition, peak cTnI predictedincreased risk of death.

Conclusion: A cTnI exceeding 0.16 µg/L on admission or during hospitalstay predicted an increased cardiac event rate at four yearsin patients admitted with suspected NSTEMI.

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