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Troponin T and quantitative ST-segment depression offer complementary prognostic information in the risk stratification of acute coronary syndrome patients

Padma Kaul, PhD^*, L. Kristin Newby, MD^*, Yuling Fu, MD, Vic Hasselblad, PhD^*, Kenneth W. Mahaffey, MD^*, Robert H. Christenson, PhD, Robert A. Harrington, MD^*, E. Magnus Ohman, MD, Eric J. Topol, MD^||, Robert M. Califf, MD^*, Frans Van de Werf, MD, PhD^¶, Paul W. Armstrong, MD^,* the PARAGON-B Investigators

^* Duke Clinical Research Institute, Durham, North Carolina, USA
University of Alberta, Edmonton, Alberta, Canada
University of Maryland Medical System, Baltimore, Maryland, USA
University of North Carolina Medical Center, Chapel Hill, North Carolina, USA
^|| Cleveland Clinic Foundation, Cleveland, Ohio, USA
^¶ Catholic University Hospital, Leuven, Belgium

View larger version (25K): [in a new window]   Figure 1 Description of the patient population. ECG = electrocardiogram; ST-dep = ST-segment depression; TnT = troponin; T– = troponin negative; T+ = Troponin positive.

View larger version (12K): [in a new window]   Figure 2 Kaplan-Meier curves of six-month survival free of death/(re)myocardial infarction. (A) Categorized by ST-segment depression categories. *Log rank statistics (0 vs. 1 mm) = 4.2 (p = 0.04). #Log rank statistic (0 vs. 2 mm) = 14.2 (p < 0.01). **Log rank statistic (1 vs. 2 mm) = 4.6 (p = 0.03). (B) Categorized by troponin status. *Log rank statistics = 10.24 (p < 0.01).

View larger version (48K): [in a new window]   Figure 3 Six-month death/(re)myocardial infarction (MI) rates by troponin quartiles.

View larger version (30K): [in a new window]   Figure 4 Six-month death/(re)myocardial infarction (MI) rates by ST-segment depression categories and troponin status. Shaded square = troponin – closed square = troponin +.