High-Sensitivity Cardiac Troponin and the Universal Definition of Myocardial Infarction
Primary result · MI or CV deathResult — go to the resultCause-specific hazard ratio 5.64 95% CI 5.12–6.22Authors' conclusion
Implementation of high-sensitivity cardiac troponin assays and the recommendations of the Universal Definition of Myocardial Infarction identified patients at high-risk of cardiovascular and noncardiovascular events but was not associated with consistent increases in treatment or improved outcomes.
Study context
- Population
- Consecutive patients with suspected ACS
- Participants
- 48,282 patients
- Comparison
- Type 1 MI vs No myocardial injury
Methodological detailscluster randomized
- Cluster randomized
Primary result
MI or CV death · 1 year
Cause-specific hazard ratio
5.64
95% CI 5.12–6.22
Type 1 MI vs No myocardial injury
cause-specific HR 5.64 (95% CI 5.12–6.22)
As reported in the abstract
Secondary outcomes
| Outcome | Cause-specific HR (95% CI) | |
|---|---|---|
| Non-CV death · 1 yearAcute myocardial injury vs No myocardial injury · highest in acute myocardial injury | 2.65 (2.33–3.01) | |
| MI or CV death in type 1 MI, after vs before implementation | 1.00 (0.82–1.21) | |
| 0.20.5125Cause-specific hazard ratio (log scale) |
Increase in diagnoses after implementation
- MI or CV death in type 1 MI, after vs before implementation: despite modest increases in antiplatelet therapy and coronary revascularization
Investigation, treatment and outcomes in type 2 MI and myocardial injury
- Increased recognition did not lead to changes in investigation, treatment or outcomes
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
High-Sensitivity Cardiac Troponin and the Universal Definition of Myocardial Infarction. Circulation. Published 7 October 2019. doi:10.
Summarised from the published abstract; every number is checked against it