Most Read Articles
3 days ago
Older women with longer endogenous oestrogen exposure and hormone therapy use are at much higher odds of having favourable cognitive status in late life, a recent study suggests.
Yesterday
In patients with atrial fibrillation (AF) and stable coronary artery disease (CAD), rivaroxaban monotherapy is noninferior to combination treatment with an antiplatelet therapy in terms of cutting the risk of cardiovascular events and mortality, according to data from the AFIRE trial.
Elvira Manzano, 2 days ago
Supplementation with omega-3 fatty acids or vitamin D3 for up to 5 years has no effect on kidney function in adults with type 2 diabetes (T2D), the VITAL-DKD* ancillary study has shown.
3 days ago
Better sleep appears to weaken pain and fatigue in older, community-dwelling adults with hip or knee osteoarthritis (OA), reports a recent study.

Sex-specific thresholds of high-sensitivity troponin identify more women with myocardial injury

23 Oct 2019

Implementing a high-sensitivity cardiac troponin I assay with sex-specific diagnostic thresholds results in identifying five times more women than men with myocardial injury, reports a study.

“Despite this increase, women received approximately one-half the number of treatments for coronary artery disease as men, and outcomes were not improved,” the investigators said.

To evaluate the impact of using a high-sensitivity cardiac troponin I assay with sex-specific thresholds for myocardial infarction (MI), the investigators enrolled consecutive patients with suspected acute coronary syndrome in a stepped-wedge, cluster-randomized controlled trial across 10 hospitals.

Myocardial injury was defined as high-sensitivity cardiac troponin I concentration >99th centile of 16 ng/l in women and 34 ng/l in men. Recurrent MI or cardiovascular (CV) death at 1 year was the primary outcome.

Overall, 48,282 patients (47 percent women) were eligible for the study. Use of the high-sensitivity cardiac troponin I assay with sex-specific thresholds led to a 42-percent increase in myocardial injury in women and a 6-percent risk in men.

Following this implementation, women with myocardial injury were still less likely than men to undergo coronary revascularization (15 percent vs 34 percent) and to receive treatment such as dual antiplatelet (26 percent vs 43 percent), statin (16 percent vs 26 percent) or other preventive therapies (p-all<0.001).

Eighteen percent and 17 percent of women with myocardial injury experienced recurrent MI or CV death 1 year before and after implementation, respectively (adjusted hazard ratio [aHR], 1.11, 95 percent CI, 0.92–1.33), as compared with 18 percent and 15 percent of men (aHR, 0.85, 0.71–1.01).

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Doctor - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
3 days ago
Older women with longer endogenous oestrogen exposure and hormone therapy use are at much higher odds of having favourable cognitive status in late life, a recent study suggests.
Yesterday
In patients with atrial fibrillation (AF) and stable coronary artery disease (CAD), rivaroxaban monotherapy is noninferior to combination treatment with an antiplatelet therapy in terms of cutting the risk of cardiovascular events and mortality, according to data from the AFIRE trial.
Elvira Manzano, 2 days ago
Supplementation with omega-3 fatty acids or vitamin D3 for up to 5 years has no effect on kidney function in adults with type 2 diabetes (T2D), the VITAL-DKD* ancillary study has shown.
3 days ago
Better sleep appears to weaken pain and fatigue in older, community-dwelling adults with hip or knee osteoarthritis (OA), reports a recent study.