The Potential for Troponin to Inform Prognosis in Patients With Stable Coronary Artery Disease
Authors: P.J. Devereaux
Journal: Annals of Internal Medicine (2018)

Editorials4 December 2018The Potential for Troponin to Inform Prognosis in Patients With Stable Coronary Artery DiseaseP.J. Devereaux, MD, PhDP.J. Devereaux, MD, PhDMcMaster University and Population Health Research Institute, Hamilton, Ontario, Canada (P.D.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-2984 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Patients with stable coronary artery disease (CAD) are at risk for myocardial infarction and death (1). Many patients with stable CAD, as well as their physicians, want high-quality prognostic information. Some physicians do cardiac stress testing in this patient population, probably because they perceive it to be the most informative prognostic test. Moreover, some physicians monitor cardiac stress testing to determine whether myocardial ischemia has been reduced by the interventions patients have received (2).In the COURAGE (Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation) trial, 314 patients with stable CAD participated in a substudy in which they had myocardial ...References1. Eikelboom JW, Connolly SJ, Bosch J, Dagenais GR, Hart RG, Shestakovska O, et al; COMPASS Investigators. Rivaroxaban with or without aspirin in stable cardiovascular disease. N Engl J Med. 2017;377:1319-1330. [PMID: 28844192] doi:10.1056/NEJMoa1709118 CrossrefMedlineGoogle Scholar2. Bradley SM, Hess E, Winchester DE, Sussman JB, Aggarwal V, Maddox TM, et al. Stress testing after percutaneous coronary intervention in the veterans affairs HealthCare system: insights from the veterans affairs clinical assessment, reporting, and tracking program. Circ Cardiovasc Qual Outcomes. 2015;8:486-92. 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[PMID: 22527794] doi:10.1007/s12350-012-9548-3 CrossrefMedlineGoogle Scholar5. Hammadah M, Kim JH, Tahhan AS, Kindya B, Liu C, Ko Y, et al. Use of high-sensitivity cardiac troponin for the exclusion of inducible myocardial ischemia. A cohort study. Ann Intern Med. 2018;169:751-60. doi:10.7326/M18-0670 LinkGoogle Scholar6. Kavsak PA, Xu L, Yusuf S, McQueen MJ. High-sensitivity cardiac troponin I measurement for risk stratification in a stable high-risk population. Clin Chem. 2011;57:1146-53. [PMID: 21700956] doi:10.1373/clinchem.2011.164574 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: McMaster University and Population Health Research Institute, Hamilton, Ontario, Canada (P.D.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-2984.Corresponding Author: P.J. Devereaux, MD, PhD, McMaster University, Department of Perioperative Medicine, David Braley Research Building, Suite C1, 237 Barton Street East, Hamilton, Ontario L8L 2X2, Canada; e-mail, [email protected]ca.This article was published at Annals.org on 6 November 2018. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoUse of High-Sensitivity Cardiac Troponin for the Exclusion of Inducible Myocardial Ischemia Muhammad Hammadah , Jeong Hwan Kim , Ayman Samman Tahhan , Bryan Kindya , Chang Liu , Yi-An Ko , Ibhar Al Mheid , Kobina Wilmot , Ronnie Ramadan , Ayman Alkhoder , Fahad Choudhary , Mohamad Mazen Gafeer , Naser Abdelhadi , Pratik Pimple , Pratik Sandesara , Bruno B. Lima , Amit J. Shah , Laura Ward , Michael Kutner , J. Douglas Bremner , David S. Sheps , Paolo Raggi , Laurence S. Sperling , Viola Vaccarino , and Arshed A. Quyyumi Metrics Cited byUsing High-Sensitivity Cardiac Troponin for the Exclusion of Inducible Myocardial Ischemia in Symptomatic Patients A Cohort StudyJoan Walter, MD, PhD, Jeanne du Fay de Lavallaz, MD, PhD, Luca Koechlin, MD, Tobias Zimmermann, MD, Jasper Boeddinghaus, MD, Ursina Honegger, MSc, Ivo Strebel, MSc, Raphael Twerenbold, MD, Melissa Amrein, MSc, Thomas Nestelberger, MD, Desiree Wussler, MD, Christian Puelacher, MD, PhD, Patrick Badertscher, MD, Michael Zellweger, MD, Gregor Fahrni, MD, Raban Jeger, MD, Christoph Kaiser, MD, Tobias Reichlin, MD, and Christian Mueller, MDBiomarkers for coronary artery disease and heart failure 4 December 2018Volume 169, Issue 11Page: 808-809KeywordsHigh sensitivity cardiac troponinIschemiaMortality probability scoreMyocardial infarctionMyocardiumNegative predictive valueRevascularizationSpecificityStable coronary artery diseaseType 2 diabetes ePublished: 6 November 2018 Issue Published: 4 December 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. 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