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Admission risk assessment by cardiac troponin T in unstable coronary artery disease: additional prognostic information from continuous ST segment monitoring

^a Department of Medicine and Cardiology, Aarhus University Hospital, Aarhus, Denmark
^* Department of Medicine and Cardiology, Sahlgrenska University Hospital, Ôstra, Gothenburg, Sweden

View larger version (69K): [in a new window]   Figure 1 Top, Trend curve of ST vector magnitude (ST-VM) from a patient with unstable angina as displayed by the vectorcardiography monitoring system. Transient increases of ST-VM 50 µV from the baseline >1 min indicate episodes of myocardial ischemia. Bottom, 12-lead ECG tracings recorded at baseline (1) and during an episode of transient myocardial ischemia (2) as indicated on the trend curve.

View larger version (11K): [in a new window]   Figure 2 Occurrence of cardiac death or AMI during 30 days of follow-up according to the level of cardiac troponin T and the presence or absence of ST segment episodes at continuous vectorcardiography ST segment monitoring. Top, Kaplan Meier curves of event-free probability of patients (n = 231) with troponin T <0.20 µg/liter or troponin T 0.20 µg/liter at inclusion (log rank test, p = 0.0006). Bottom, Kaplan Meier curves of event-free probability of patients (n = 214) without or with one ST segment (ST-VM) episode or more at continuous ST segment monitoring within 24 h of inclusion (log rank test, p = 0.0001). ST-VM = ST vector magnitude.

View larger version (18K): [in a new window]   Figure 3 Flow of patients according to the level of cardiac troponin T at inclusion (cut-off value 0.20 µg/liter), the presence or absence of ST segment (ST-VM) episodes at continuous vectorcardiography ST segment monitoring within 24 h of inclusion, and event rate (cardiac death or myocardial infarction) after 30 days of follow-up. In 18 patients, no cVST analysis was performed due to the presence of bundle branch block, <16 h of cVST performed or because of technical problems. cTnT = cardiac troponin T. ST-VM = ST vector magnitude.