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Cardiac Troponin for Risk Assessment and Management of Non-ST-Elevation Acute Coronary Syndrome

  • Bertil Lindahl
Part of the Contemporary Cardiology book series (CONCARD)

Abstract

The clinical history, standard 12-lead electrocardiogram (ECG), and markers of myocardial necrosis constitute the basis for diagnosis and accurate risk assessment in patients with suspected of a non-ST-elevation acute coronary syndrome (NSTEACS). Cardiac troponin T and cardiac troponin I are ideal biochemical markers for the detection of myocardial necrosis in unstable patients who have repeated episodes of ischemia of varying intensity and several days’ duration, owing to their high sensitivity and specificity and their long duration of elevation. The troponins are independently predictive of mortality as well as of new or recurrent acute myocardial infarction after an episode of NSTEACS. By integrating the clinical history, ECG findings, and troponin results, it is possible to stratify the patients into low-, intermediate-, and high-risk groups. In addition, troponin results are useful for selecting patients who benefit from treatment with lowmolecular-weight heparin, glycoprotein IIb/IIIa antagonists, and invasive management.

Key Words

Non-ST-elevation acute coronary syndrome acute myocardial infarction unstable angina troponin T troponin C electrocardiogram diagnosis risk assessment 

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Copyright information

© Humana Press Inc., Totowa, NJ 2006

Authors and Affiliations

  • Bertil Lindahl
    • 1
  1. 1.Department of Cardiology and Uppsala Clinical Research CenterUniversity HospitalUppsalaSweden

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