Clinical Chemistry Link to Randox Laboratories Web Site
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Clinical Chemistry 46: 1597-1603, 2000;
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit an electronic Letter to
the Editor about this paper
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via ISI Web of Science (24)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by de Winter, R. J.
Right arrow Articles by Sanders, G. T.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by de Winter, R. J.
Right arrow Articles by Sanders, G. T.
Related Collections
Right arrow Evidence Based Laboratory Medicine and Test Utilization
Right arrow Proteomics and Protein Markers
(Clinical Chemistry. 2000;46:1597-1603.)
© 2000 American Association for Clinical Chemistry, Inc.

Articles

C-Reactive Protein and Cardiac Troponin T in Risk Stratification: Differences in Optimal Timing of Tests Early after the Onset of Chest Pain

Robbert J. de Winter1,a, Johan Fischer2, Radha Bholasingh1, Jan P. van Straalen2, Thyra de Jong2, Jan G.P. Tijssen3 and Gerard T. Sanders2

Departments of
1 Cardiology,
2 Clinical Chemistry, and
3 Clinical Epidemiology and Biostatistics, Academic Medical Center, University of Amsterdam, 1100 DD Amsterdam, The Netherlands.
a Address correspondence to this author at: Department of Cardiology, B2-137, Academic Medical Center, Meibergdreef 9, PO Box 22660, 1100 DD Amsterdam, The Netherlands. Fax 31-20-6962609; e-mail r.j.dewinter{at}amc.uva.nl

Background: Increased C-reactive protein (CRP) is an important prognostic indicator for early risk stratification in patients with an acute coronary syndrome (ACS), independent of, and in combination with, increased cardiac troponin T (cTnT). However, increases in both cTnT and CRP also occur secondary to myocardial damage.

Methods and Results: In 156 consecutive patients, early release kinetics of CRP and cTnT were analyzed. The cutoff values were 3.0 mg/L for CRP and 0.1 µg/L for cTnT. In the 75 patients with a CRP below the cutoff on admission, there was little change in CRP until 8 h after the onset of symptoms. At 12 h after the onset of symptoms, the cumulative proportions of abnormal CRP and cTnT in non-ST elevation ACS patients were 27% and 89%, respectively (P <0.01). During the first 24 h after the onset of symptoms, the median time above the cutoff was 20 h for CRP and 5 h for cTnT (P <0.0001). CRP was below the cutoff on admission significantly more often among patients receiving thrombolytic therapy than in patients without an indication for reperfusion therapy (51% vs 28%; P = 0.004).

Conclusions: Increased CRP as an early independent risk indicator should be measured as soon as possible after the onset of symptoms, whereas increased cTnT is most reliable at 12 or more hours after the onset of symptoms.




The following articles in journals at HighWire Press have cited this article:


Home page
 Clin. Chem.Home page
B. M. Scirica, D. A. Morrow, C. P. Cannon, J. A. de Lemos, S. Murphy, M. S. Sabatine, S. D. Wiviott, N. Rifai, C. H. McCabe, E. Braunwald, et al.
Clinical Application of C-Reactive Protein Across the Spectrum of Acute Coronary Syndromes
Clin. Chem., October 1, 2007; 53(10): 1800 - 1807.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
NACB WRITING GROUP MEMBERS, D. A. Morrow, C. P. Cannon, R. L. Jesse, L. K. Newby, J. Ravkilde, A. B. Storrow, A. H.B. Wu, and R. H. Christenson
National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines: Clinical Characteristics and Utilization of Biochemical Markers in Acute Coronary Syndromes
Circulation, April 3, 2007; 115(13): e356 - e375.
[Full Text] [PDF]

Home page
 Clin. Chem.Home page
NACB WRITING GROUP MEMBERS, D. A. Morrow, C. P. Cannon, R. L. Jesse, L. K. Newby, J. Ravkilde, A. B. Storrow, A. H.B. Wu, R. H. Christenson, NACB COMMITTEE MEMBERS, et al.
National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines: Clinical Characteristics and Utilization of Biochemical Markers in Acute Coronary Syndromes
Clin. Chem., April 1, 2007; 53(4): 552 - 574.
[Full Text] [PDF]

Home page
 QJMHome page
R.L. Soiza, S.J. Leslie, P. Williamson, S. Wai, K. Harrild, N.R. Peden, and A.D. Hargreaves
Risk stratification in acute coronary syndromes--does the TIMI risk score work in unselected cases?
QJM, February 1, 2006; 99(2): 81 - 87.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
R.J. de Winter, G.S. Heyde, K.T. Koch, J. Fischer, J.P. van Straalen, M. Bax, C.E. Schotborgh, K.J. Mulder, G.T. Sanders, J.J. Piek, et al.
The prognostic value of pre-procedural plasma C-reactive protein in patients undergoing elective coronary angioplasty
Eur. Heart J., June 2, 2002; 23(12): 960 - 966.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2000 by the American Association for Clinical Chemistry.