High-sensitivity cardiac troponin T and prognosis in patients with ST-segment elevation myocardial infarction
Ndrepepa G, Kufner S, Hoyos M, Harada Y, Xhepa E, Hieber J, Cassese S, Fusaro M, Laugwitz KL, Schunkert H, Kastrati A (2018)
Publication Type: Journal article
Publication year: 2018
Journal
Book Volume: 72
Pages Range: 220-226
Journal Issue: 3
DOI: 10.1016/j.jjcc.2018.02.014
Abstract
Background: Evidence on the use of high-sensitivity cardiac troponins (hs-cTn) to risk-stratify patients with ST-segment elevation myocardial infarction (STEMI) is limited. Methods: We assessed the prognostic value of preprocedural (admission) and peak postprocedural hs-cTnT in 818 patients with STEMI treated with primary percutaneous coronary intervention (PPCI). Preprocedural and peak postprocedural hs-cTnT was measured. The primary outcome was 3-year all-cause mortality. Results: The median values of preprocedural and peak postprocedural hs-cTnT were 153 ng/L and 1980 ng/L. Overall, 134 patients died during the follow-up. There were 85 deaths in patients with preprocedural hs-cTnT >median value and 49 deaths in patients with preprocedural hs-cTnT ≤median value [Kaplan–Meier estimates of mortality, 22.2% and 13.5%; unadjusted hazard ratio (HR) = 1.88, 95% confidence interval (CI) 1.32–2.67, p < 0.001]. According to peak postprocedural hs-cTnT, there were 84 deaths in patients with postprocedural hs-cTnT >median value and 50 deaths in patients with postprocedural hs-cTnT ≤median value [Kaplan–Meier estimates of mortality, 22.3% and 13.4%; unadjusted HR = 1.82 (1.28–2.59), p < 0.001]. After adjustment, preprocedural [adjusted HR = 1.08 (1.03–1.12), p < 0.001] and peak postprocedural hs-cTnT value [adjusted HR = 1.06 (1.04–1.08), p < 0.001] were independently associated with 3-year mortality (with risk estimates calculated per 70 × 99th upper reference limit of hs-cTnT). The C statistic of multivariable model increased from 0.868 (0.841–0.895) to 0.872 (0.845–0.898) after incorporation of preprocedural hs-cTnT (p = 0.050) and to 0.874 (0.846–0.899) after incorporation of the postprocedural hs-cTnT into the model (p = 0.035). Conclusions: In conclusion, admission or peak postprocedural hs-cTnT is independently associated with the risk for 3-year mortality in patients with STEMI undergoing PPCI.
Involved external institutions
Germany (DE)How to cite
APA:
Ndrepepa, G., Kufner, S., Hoyos, M., Harada, Y., Xhepa, E., Hieber, J.,... Kastrati, A. (2018). High-sensitivity cardiac troponin T and prognosis in patients with ST-segment elevation myocardial infarction. Journal of Cardiology, 72(3), 220-226. https://doi.org/10.1016/j.jjcc.2018.02.014
MLA:
Ndrepepa, Gjin, et al. "High-sensitivity cardiac troponin T and prognosis in patients with ST-segment elevation myocardial infarction." Journal of Cardiology 72.3 (2018): 220-226.
BibTeX: Download