908-111 Prognostic Value of Troponin T and CRP Levels in pts with Unstable Angina

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Troponin T (TT), a specific marker of myocardial cell damage, and C reactive protein (CAP), an acute phase reactant, were found to be prognostic of outcome in unstable angina (UA) in different studies. We assessed the sensitivity and specificity of these markers for myocardial infarction (MI), death (D) and for the need of revascularization within a week after admission (R) in a group of 90 pts with UA. Blood samples for n and CAP measurement were taken on admission. 18/90 pts (20%) had elevated TT levels on admission (mean 0.8, range 0.2–4.3 μ g/l, normal values < 0.2 μ g/l); 7 (39%) of these pts had MI or D and 3 (17%) had A. 72/90 pts (80%) had normal TT values; 8 (11%) of these pts had Mlor D (p = 0.013) and 12 (17%) had R. Sensitivity of elevated n values for MI or D was 67% and specificity 85%. CRP was measured in 83 pts and was elevated (normal values < 3 mg/dl) in 50 (62%).10 (20%) ofthese pts had MI or D and 11 (22%) had R. Only 2/33 pts (6%) with normal CAP levels had MI or D and 3/33 (9%) had A. Sensitivity of CAP > 3 mg/dl for MI or D was 83% and specificity 44%. 20/83 pts (24%) had CAP values > 10 mg/dl; 8 (40%) of these pts had MI or D (p < 0.0007 versus pts with CAP < 10 mg/dl) and 8 pts (40%) required A(p = 0.004 versus pts with CAP < 10 mg/dl). Sensitivity of CAP > 10 mg/dl for MI or D was 67% and for A was 57%; specificity for MI or D and also for A was 83%. The combination of elevated values of n and CAP was shown in 14/83 pts (17%); 6 (43%) of these pts had MI or D, while only 1/31 pts (3%) with normal n and CAP had MI or D (p = 0.003). Sensitivity of elevated nand CAP levels for MI or Awas 43% and specificity 79%. Positive predictive value was 43% and negative predictive value 97%. These results indicate that n and CAP values on the admission are important prognostic predictors of outcome in pts with UA, particularly when both are elevated.