Prognostic value of high sensitive troponin in patients with acute coronary

The second most common presenting complaint of patients in Emergency Department is chest pain. Since acute coronary syndrome has a high likelihood of morbidity and mortality, these patients are considered risky. Cardiac troponin assay is the most commonly used test across the world and the assay's reliability has been proved (and has been proved reliable). In this study, we aimed to determine the prognostic value of high-sensitive troponin in one-month and three-month mortality. This retrospective study has been conducted in September, 2014 and aimed to analyze patient records of the patients who presented to Akdeniz University Hospital Adult Emergency Department between January 1st 2013 and June 31st 2014. Akdeniz University Hospital Emergency Department is a tertiary medical center ED with an annual census of 100.000 patients. Records of patients included in this study were scanned in the national death database to determine deceased patients. The cause of death determined by checking hospital records or by reaching the patients via telephone. 11.853 patients were included in the study, composed of 6487 men and 5366 women. Mean age of patients was 57±17. AUC (area under the curve) value of hsTn value obtained at the time of ED presentation for predicting cardiac mortality at the end of a 30-day period is 0.869 (95% CI: 0.863-0.875). The cut-off value of high sensitive troponin for 99% of the normal population is 14 and sensitivity and specificity for this value are 87% (95% CI: 77%-94%) and, 69% (95% CI: 68% - 70%) respectively. AUC value of hsTn value obtained at the time of ED presentation for predicting cardiac mortality at the end of a 90-day is 0.864 (95% CI: 0.858-0.870). The cut-off value of high sensitive troponin for 99% of the normal population is 14 and sensitivity and specificity for this value are 87% (95% CI: 79%-93%) and, 69% (95% CI: 68% - 70%) respectively. High sensitive troponin assay obtained at the time of ED presentation lacks of predicting 30-day and 90-day cardiac mortality. However, as the high sensitive troponin results regress to trace values, the prognostic value increases