1. Management and outcomes of patients with unstable angina with undetectable, normal, or intermediate hsTnT levels
- Author
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Christoph Riedle, Mehrshad Vafaie, Hauke Hund, Jochen Gandowitz, Matthias Mueller-Hennessen, Hugo A. Katus, Julia Löhr, Kiril M. Stoyanov, Moritz Biener, and Evangelos Giannitsis
- Subjects
Acute coronary syndrome ,medicine.medical_specialty ,business.industry ,Unstable angina ,medicine.medical_treatment ,Stress testing ,Percutaneous coronary intervention ,General Medicine ,Odds ratio ,030204 cardiovascular system & hematology ,medicine.disease ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Conventional PCI ,medicine ,Cardiology ,030212 general & internal medicine ,Myocardial infarction ,Cardiology and Cardiovascular Medicine ,business - Abstract
Patients with unstable angina (UA) are regarded to be at low risk for future coronary events. Guidelines discourage routine coronary angiography and recommend early discharge after individualized risk stratification. The relative value of clinical risk indicators as compared to cardiac troponin (cTn) alone is unsettled in the era of high-sensitivity cardiac troponin (hsTn) assays. We aimed to investigate the clinical characteristics, therapies, and outcomes of UA patients with different hsTnT concentrations. During 12 months, 2525 patients were enrolled. UA was defined as unstable symptoms and either undetectable ( 99th percentile but not unstable symptoms carried an independent 3.25-fold (1.78–5.93) higher risk for all-cause death after adjustment for other clinical risk indicators or the GRACE score. Utilization of guideline-recommended therapies was high albeit lower than for non-ST-elevation myocardial infarction (NSTEMI). Significantly fewer patients with UA received dual antiplatelet therapy (DAPT, odds ratio (OR) 0.51 [95% CI 0.44–0.59], P
- Published
- 2019