Troponin Marker for Acute Coronary Occlusion and Patient Outcome Following Cardiac Arrest
| Autor: | Alan C. Heffner, Jonathan R. Studnek, Katherine A. Mayer, Shana L. Ward, Kathi M. Kraft, David Pearson, Catherine M. Wares, Michael S. Runyon |
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| Rok vydání: | 2015 |
| Předmět: |
Male
Cardiac Catheterization medicine.medical_specialty medicine.medical_treatment lcsh:Medicine Cardiac arrest percutaneous coronary intervention Percutaneous Coronary Intervention Internal medicine Troponin I medicine Humans Retrospective Studies Original Research Cardiac catheterization biology business.industry lcsh:R lcsh:Medical emergencies. Critical care. Intensive care. First aid Percutaneous coronary intervention Retrospective cohort study lcsh:RC86-88.9 General Medicine Middle Aged Cardiac arrest Health Outcomes Troponin Treatment Outcome Coronary Occlusion Coronary occlusion Cohort Conventional PCI Emergency Medicine biology.protein Cardiology Female business Biomarkers Out-of-Hospital Cardiac Arrest |
| Zdroj: | Western Journal of Emergency Medicine Western Journal of Emergency Medicine, Vol 16, Iss 7, Pp 1007-1013 (2015) Pearson, David Andres; Wares, Catherine M.; Mayer, Katherine A.; Runyon, Michael S.; Studnek, Jonathan R.; Ward, Shana L.; et al.(2015). Troponin Marker for Acute Coronary Occlusion and Patient Outcome Following Cardiac Arrest. Western Journal of Emergency Medicine, 16(7). doi: 10.5811/westjem.2015.10.28346. Retrieved from: http://www.escholarship.org/uc/item/76v5q4sc |
| ISSN: | 1936-9018 1936-900X |
| Popis: | Author(s): Pearson, David Andres; Wares, Catherine M.; Mayer, Katherine A.; Runyon, Michael S.; Studnek, Jonathan R.; Ward, Shana L.; Kraft, Kathi M.; Heffner, Alan C. | Abstract: Introduction: The utility of troponin as a marker for acute coronary occlusion and patient outcome after out-of-hospital cardiac arrest (OHCA) is unclear. We sought to determine whether initial or peak troponin was associated with percutaneous coronary intervention (PCI), OHCA survival or neurological outcome. Methods: Single-center retrospective-cohort study of OHCA patients treated in a comprehensive clinical pathway from November 2007 to October 2012. Troponin I levels were acquired at presentation, four and eight hours after arrest, and then per physician discretion. Cardiac catheterization was at the cardiologist’s discretion. Survival and outcome were determined at hospital discharge, with cerebral performance category score 1-2 defined as a good neurological outcome. Results: We enrolled 277 patients; 58% had a shockable rhythm, 44% survived, 41% good neurological outcome. Of the 107 (38%) patients who underwent cardiac catheterization, 30 (28%) had PCI. Initial ED troponin (median, ng/mL) was not different in patients requiring PCI vs no PCI (0.32 vs 0.09, p=0.06), although peak troponin was higher (4.19 versus 1.57, p=0.02). Of the 85 patients who underwent cardiac catheterization without STEMI (n=85), there was no difference in those who received PCI vs no PCI in initial troponin (0.22 vs 0.06, p=0.40) or peak troponin (2.58 vs 1.43, p=0.27). Regarding outcomes, there was no difference in initial troponin in survivors versus non-survivors (0.09 vs 0.22, p=0.11), or those with a good versus poor neurological outcome (0.09 vs 0.20, p=0.11). Likewise, there was no difference in peak troponin in survivors versus non-survivors (1.64 vs 1.23, p=0.07), or in those with a good versus poor neurological outcome (1.57 vs 1.26, p=0.14).Conclusion: In our single-center patient cohort, peak troponin, but not initial troponin, was associated with higher likelihood of PCI, while neither initial nor peak troponin were associated with survival or neurological outcome in OHCA patients. |
| Databáze: | OpenAIRE |
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