Relation of Left Ventricular Mass and Infarct Size in Anterior Wall ST-Segment Elevation Acute Myocardial Infarction (from the EMBRACE STEMI Clinical Trial)

Autor: C. Michael Gibson, Serge Korjian, Jim Carr, Donald Szlosek, Haytham Allaham, Sujit Routray, Nathan Michalak, W. Douglas Weaver, Robert P. Giugliano, Brandon J. Neal, Luke Rusowicz-Orazem, Yazan Daaboul, Gerald Chi, Turky Alkathery, Madeleine Cochet, Robert A. Kloner, Purva Jain, Laura Goodell
Rok vydání: 2016
Předmět:
Male
medicine.medical_specialty
Time Factors
medicine.medical_treatment
Heart Ventricles
030204 cardiovascular system & hematology
Sensitivity and Specificity
Antioxidants
03 medical and health sciences
0302 clinical medicine
Percutaneous Coronary Intervention
Double-Blind Method
Predictive Value of Tests
Internal medicine
Troponin I
Medicine
ST segment
Creatine Kinase
MB Form
Humans
cardiovascular diseases
030212 general & internal medicine
Myocardial infarction
Anterior Wall Myocardial Infarction
Aged
Body surface area
biology
business.industry
Myocardium
Area under the curve
Percutaneous coronary intervention
Middle Aged
medicine.disease
Magnetic Resonance Imaging
Treatment Outcome
cardiovascular system
biology.protein
Cardiology
ST Elevation Myocardial Infarction
Creatine kinase
Female
Cardiology and Cardiovascular Medicine
business
Oligopeptides
Biomarkers
Zdroj: The American journal of cardiology. 118(5)
ISSN: 1879-1913
Popis: Biomarker measures of infarct size and myocardial salvage index (MSI) are important surrogate measures of clinical outcomes after a myocardial infarction. However, there is variability in infarct size unaccounted for by conventional adjustment factors. This post hoc analysis of Evaluation of Myocardial Effects of Bendavia for Reducing Reperfusion Injury in Patients With Acute Coronary Events (EMBRACE) ST-Segment Elevation Myocardial Infarction (STEMI) trial evaluates the association between left ventricular (LV) mass and infarct size as assessed by areas under the curve for creatine kinase-MB (CK-MB) and troponin I release over the first 72 hours (CK-MB area under the curve [AUC] and troponin I [TnI] AUC) and the MSI. Patients with first anterior STEMI, occluded left anterior descending artery, and available LV mass measurement in EMBRACE STEMI trial were included (n = 100) (ClinicalTrials.govNCT01572909). MSI, end-diastolic LV mass on day 4 cardiac magnetic resonance, and CK-MB and troponin I concentrations were evaluated by a core laboratory. After saturated multivariate analysis, dominance analysis was performed to estimate the contribution of each independent variable to the predicted variance of each outcome. In multivariate models that included age, gender, body surface area, lesion location, smoking, and ischemia time, LV mass remained independently associated with biomarker measures of infarct size (CK-MB AUC p = 0.02, TnI AUC p = 0.03) and MSI (p = 0.003). Dominance analysis demonstrated that LV mass accounted for 58%, 47%, and 60% of the predicted variances for CK-MB AUC, TnI AUC, and MSI, respectively. In conclusion, LV mass accounts for approximately half of the predicted variance in biomarker measures of infarct size. It should be considered as an adjustment variable in studies evaluating infarct size.
Databáze: OpenAIRE
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