High-sensitivity cardiac troponin T and prognosis in patients with ST-segment elevation myocardial infarction.

Ndrepepa, Gjin; Kufner, Sebastian; Hoyos, Magdalena; Harada, Yukinori; Xhepa, Erion; Hieber, Julia; Cassese, Salvatore; Fusaro, Massimiliano; Laugwitz, Karl-Ludwig; Schunkert, Heribert; Kastrati, Adnan

doi:10.1016/j.jjcc.2018.02.014

2018

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Document type:: Article; Journal Article
Author(s):: Ndrepepa, Gjin; Kufner, Sebastian; Hoyos, Magdalena; Harada, Yukinori; Xhepa, Erion; Hieber, Julia; Cassese, Salvatore; Fusaro, Massimiliano; Laugwitz, Karl-Ludwig; Schunkert, Heribert; Kastrati, Adnan
Title:: High-sensitivity cardiac troponin T and prognosis in patients with ST-segment elevation myocardial infarction.
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 153ng/L and 1980ng/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.
Journal title abbreviation:: J Cardiol
Year:: 2018
Journal volume:: 72
Journal issue:: 3
Pages contribution:: 220-226
Fulltext / DOI:: doi:10.1016/j.jjcc.2018.02.014
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/29599097
Print-ISSN:: 0914-5087
TUM Institution:: I. Medizinische Klinik und Poliklinik (Kardiologie); Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (Prof. Schunkert)
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Occurrences:

mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Lehr- und Forschungskooperationen mit den Kliniken und Instituten am Deutschen Herzzentrum Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (DHM) (Prof. Schunkert)2018

mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Klinik und Poliklinik für Innere Medizin I, Kardiologie (Prof. Laugwitz)2018