BACKGROUND: The additional diagnostic and prognostic information provided by delta high-sensitivity troponin T (hs- @entity10020 ) in @entity1 with acute @entity662 and hs- @entity10020 elevation remains unclear. METHODS: The study group consisted of 601 @entity1 presenting at the emergency department with non-ST-segment elevation acute @entity662 and hs- @entity10020 elevation after two determinations (admission and within the first six hours). Maximum hs- @entity10020 and delta hs- @entity10020 (absolute or percentage change between the two measurements) were considered. Cutoff values were optimized using the quartile distribution for the endpoints. The endpoints were diagnostic (significant stenosis in the coronary angiogram) and prognostic ( @entity204 or recurrent @entity583 at one year). RESULTS: Regarding the diagnostic endpoint, 114 @entity1 showed a normal angiogram. Both maximum hs- @entity10020    80 ng/ml (OR 2.5, 95% CI 1.3-4.8, P=0.005) and delta hs- @entity10020    20 ng/l (OR 2.1, 95% CI 1.1-4.0, P=0.02) median value cutoffs were related to significant @entity3979 . Furthermore, the combination of hs-cTn <80 ng/l and delta hs-cTn <20 ng/l showed the lowest probability of significant @entity3979 (OR 0.3, 95% CI 0.1-0.4, P=0.001). During follow-up, 86 @entity1 experienced the prognostic endpoint. After full adjustment for clinical data, maximum hs- @entity10020    30 ng/l, first quartile cutoff, was related to the outcome (HR 1.8, 95% CI 1.0-3.4, P=0.05), while delta hs- @entity10020 , either absolute or percentage change, lacked prognostic value. CONCLUSIONS: Maximum hs- @entity10020 captures all the prognostic information provided by hs- @entity10020 in non-ST-segment elevation acute @entity662 . Low maximum and low delta hs- @entity10020 are associated with a normal coronary angiogram, which could make the final diagnosis challenging in some cases.

Usefulness of delta troponin for diagnosis and prognosis assessment of non-ST-segment elevation acute XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity662 :: ('MESH:D002637', 'Disease') :: ['chest pain'] @entity3979 :: ('MESH:D023921', 'Disease') :: ['coronary stenosis'] @entity10020 :: ('7139', 'Gene') :: ['cTnT'] @entity583 :: ('MESH:D009203', 'Disease') :: ['myocardial infarction'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death']
@entity662 :: (MESH:D002637,Disease) :: ['chest pain']
