Olatunde Ola, Jonathan D Knott, Laura De Michieli, Ronstan Lobo, Joshua Slusser, Ashok Akula, Marshall Dworak, Tahir Tak, Charles Cagin, Yader Sandoval, Allan S Jaffe
{"title":"过渡到高敏感性心肌肌钙蛋白T后，不稳定型心绞痛的发生率缺乏变化。","authors":"Olatunde Ola, Jonathan D Knott, Laura De Michieli, Ronstan Lobo, Joshua Slusser, Ashok Akula, Marshall Dworak, Tahir Tak, Charles Cagin, Yader Sandoval, Allan S Jaffe","doi":"10.1016/j.amjmed.2025.05.010","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated the impact of high-sensitivity cardiac troponin T (hs-cTnT) implementation on the incidence and cardiac evaluations of patients with unstable angina.</p><p><strong>Methods: </strong>Retrospective US cohort study of emergency department patients evaluated with troponin (cTn) measurements transition from 4th generation cTnT (6 months pre-implementation) to 5th generation hs-cTnT assay (6 months post-implementation).</p><p><strong>Results: </strong>Only 39 patients were diagnosed with unstable angina; 18 with 4th cTnT and 21 with 5th hs-cTnT. With 4th generation cTnT assay almost all (94.4%) had values < 99th URL whereas 33.3% had at least one value > 99th (mean = 25ng/L and peak = 26 ng/L) with hs-cTnT. The latter had underlying structural heart disease. There were no significant differences in cardiac evaluations with echocardiography, stress testing or invasive coronary angiography (between groups.</p><p><strong>Conclusions: </strong>The incidence of unstable angina did not change with transition to 5th generation hs-cTnT assay. However, stable hs-cTnT increases were more common likely due to underlying structural heart disease. There were no changes in frequency of cardiac evaluations.</p>","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":2.5000,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Lack of Change in the Incidence of Unstable Angina after Transition to High-Sensitivity Cardiac Troponin T.\",\"authors\":\"Olatunde Ola, Jonathan D Knott, Laura De Michieli, Ronstan Lobo, Joshua Slusser, Ashok Akula, Marshall Dworak, Tahir Tak, Charles Cagin, Yader Sandoval, Allan S Jaffe\",\"doi\":\"10.1016/j.amjmed.2025.05.010\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This study evaluated the impact of high-sensitivity cardiac troponin T (hs-cTnT) implementation on the incidence and cardiac evaluations of patients with unstable angina.</p><p><strong>Methods: </strong>Retrospective US cohort study of emergency department patients evaluated with troponin (cTn) measurements transition from 4th generation cTnT (6 months pre-implementation) to 5th generation hs-cTnT assay (6 months post-implementation).</p><p><strong>Results: </strong>Only 39 patients were diagnosed with unstable angina; 18 with 4th cTnT and 21 with 5th hs-cTnT. With 4th generation cTnT assay almost all (94.4%) had values < 99th URL whereas 33.3% had at least one value > 99th (mean = 25ng/L and peak = 26 ng/L) with hs-cTnT. The latter had underlying structural heart disease. There were no significant differences in cardiac evaluations with echocardiography, stress testing or invasive coronary angiography (between groups.</p><p><strong>Conclusions: </strong>The incidence of unstable angina did not change with transition to 5th generation hs-cTnT assay. However, stable hs-cTnT increases were more common likely due to underlying structural heart disease. There were no changes in frequency of cardiac evaluations.</p>\",\"PeriodicalId\":50807,\"journal\":{\"name\":\"American Journal of Medicine\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-05-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.amjmed.2025.05.010\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.amjmed.2025.05.010","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Lack of Change in the Incidence of Unstable Angina after Transition to High-Sensitivity Cardiac Troponin T.
Objective: This study evaluated the impact of high-sensitivity cardiac troponin T (hs-cTnT) implementation on the incidence and cardiac evaluations of patients with unstable angina.
Methods: Retrospective US cohort study of emergency department patients evaluated with troponin (cTn) measurements transition from 4th generation cTnT (6 months pre-implementation) to 5th generation hs-cTnT assay (6 months post-implementation).
Results: Only 39 patients were diagnosed with unstable angina; 18 with 4th cTnT and 21 with 5th hs-cTnT. With 4th generation cTnT assay almost all (94.4%) had values < 99th URL whereas 33.3% had at least one value > 99th (mean = 25ng/L and peak = 26 ng/L) with hs-cTnT. The latter had underlying structural heart disease. There were no significant differences in cardiac evaluations with echocardiography, stress testing or invasive coronary angiography (between groups.
Conclusions: The incidence of unstable angina did not change with transition to 5th generation hs-cTnT assay. However, stable hs-cTnT increases were more common likely due to underlying structural heart disease. There were no changes in frequency of cardiac evaluations.
期刊介绍：
The American Journal of Medicine - "The Green Journal" - publishes original clinical research of interest to physicians in internal medicine, both in academia and community-based practice. AJM is the official journal of the Alliance for Academic Internal Medicine, a prestigious group comprising internal medicine department chairs at more than 125 medical schools across the U.S. Each issue carries useful reviews as well as seminal articles of immediate interest to the practicing physician, including peer-reviewed, original scientific studies that have direct clinical significance and position papers on health care issues, medical education, and public policy.
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