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The prognostic value of troponin in patients with non-ST elevation acute coronary syndromes: a meta-analysis

Paul A. Heidenreich, MD, MS, FACC^* , Thomas Alloggiamento, MD^* , Kathryn Melsop, MS, Kathryn M. McDonald, MM , Alan S. Go, MD and Mark A. Hlatky, MD, FACC

^* Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
Departments of Health Research and Policy and Medicine, Stanford University, Stanford, California, USA
Division of Research, Kaiser Permanente Medical Care Program (Northern California), Oakland, California, USA
Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA

View larger version (14K): [in a new window]   Figure 1 The odds ratio for increased mortality with a positive troponin I for clinical trials and cohort studies. Data are displayed for each study with at least one death in both positive and negative troponin T subgroups. The summary odds ratio assumes random effects. Error bars represent 95% confidence intervals.

View larger version (18K): [in a new window]   Figure 2 The odds ratio for increased mortality with a positive troponin T for clinical trials and cohort studies. Data are displayed for each study with at least one death in both positive and negative troponin T subgroups. The summary odds ratio assumes random effects. Error bars represent 95% confidence intervals.

View larger version (11K): [in a new window]   Figure 3 The association between the mortality rate for patients with an initial negative troponin test (within 6 h of presentation) and the proportion of patients in each study with electrocardiogram (ECG) evidence of ischemia. The higher risk cohorts (more ECG ischemia) had a higher mortality rate. Evidence of ischemia was defined separately for each trial but usually consisted of ST depression or transient ST elevation. Data from patients with persistent ST elevation are not included. Squares = negative TnI (troponin I); circles = negative TnT (troponin T).