Quartiles of Peak Troponin Are Associated with Long-term Risk of Death in Type 1 and STEMI, but Not in Type 2 or NSTEMI Patients
| Autor: | Amit A. Patel, Wayne E. Cascio, Hiren R. Patel, Christopher P. Porterfield, Heang M. Lim, Manuel A. Gonzalez, Summiyah Nasir, Dana J. Eilen, Joseph D. Babb, Rana A. Marzouq, John D. Rose |
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| Rok vydání: | 2009 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Myocardial Infarction Clinical Investigations Kaplan-Meier Estimate Risk Assessment Predictive Value of Tests Recurrence Internal medicine Creatine Kinase MB Form Humans Medicine Prospective Studies cardiovascular diseases Myocardial infarction Risk factor health care economics and organizations Aged Proportional Hazards Models biology business.industry Hazard ratio General Medicine Middle Aged medicine.disease Troponin Confidence interval Surgery Long term risk Quartile biology.protein Cardiology Female Cardiology and Cardiovascular Medicine business Biomarkers Mace |
| Zdroj: | Clinical Cardiology. 32:575-583 |
| ISSN: | 1932-8737 0160-9289 |
| Popis: | BACKGROUND: The prognostic value of peak cardiac troponin (cTn) in different types of acute myocardial infarction (AMI) under the universal clinical classification is unknown. HYPOTHESIS: We tested the hypothesis that the prognostic value of cTn varies with its peak level and type of AMI. METHODS: We studied 345 consecutive patients with AMI with mean follow‐up of 30.6 months according to quartiles of peak cTn level (QPTL) and the type of AMI. The study outcomes were the major adverse cardiovascular events (MACE; composite of all causes of mortality and recurrent AMI) and the individual components of MACE. RESULTS: The study included patients with AMI Type 1 (n = 276), type 2 (n = 54), ST‐segment elevation myocardial infarction (STEMI; n = 159), and non‐ST‐segment elevation myocardial infarction (NSTEMI; n = 186). Overall, peak cTn level was an independent predictor of MACE (hazard ratio [HR]: 1.001, 95% confidence interval [CI]: 1.000–1.003, P = 0.01) and death (HR: 1.002, 95% CI: 1.001–1.004, P = 0.003), but not of recurrent AMI. The highest risk of MACE and death was in the highest QPTL (61.6%, P = .016 and 66.3%, P = 0.021, respectively) while the highest risk of recurrent AMI was in the lowest QPTL (83.7%, P = 0.04). Quartiles of peak cTn level were significantly associated with increased risk of MACE and death in patients with Type 1 (all P = 0.01) and STEMI (P = 0.01 and P = 0.02, respectively), but no association existed in type 2 or NSTEMI patients. CONCLUSIONS: Overall, peak cTn predicts the risk of MACE and death but not the risk of AMI. While in Type 1 and STEMI patients, QPTL are associated with risk of MACE and death, no association exists in type 2 or NSTEMI patients. Copyright © 2009 Wiley Periodicals, Inc. |
| Databáze: | OpenAIRE |
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