The significance of circulating levels of both cardiac troponin I and high‐sensitivity C reactive protein for the prediction of intravenous thrombolysis outcome in patients with ST‐segment elevation myocardial infarction
| Autor: | Stefanos G. Foussas, Denis C Xenos, Christopher D. Olympios, Nikolaos G. Patsourakos, Filippos A. Anastassiadis, Evdokia N. Adamopoulou, Charalambos S. Apostolatos, Spyros K. Argyrakis, Michael N. Zairis, Stamatis S. Makrygiannis, Joseph K Papadopoulos, Markos P. Glyptis, Stavros J. Manousakis |
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| Jazyk: | angličtina |
| Rok vydání: | 2007 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Myocardial Infarction Electrocardiography Fibrinolytic Agents Internal medicine Troponin I Fibrinolysis medicine ST segment Humans Streptokinase Thrombolytic Therapy Myocardial infarction Prospective Studies Treatment Failure Prospective cohort study Aged Proportional Hazards Models medicine.diagnostic_test business.industry ST elevation Thrombolysis Middle Aged medicine.disease Prognosis Surgery C-Reactive Protein Logistic Models Cardiology Female Cardiology and Cardiovascular Medicine business Acute Coronary Syndromes Biomarkers Follow-Up Studies |
| Popis: | To evaluate, using continuous 12-lead ECG ST-segment monitoring, the role of circulating levels of both cardiac troponin I (cTnI) and high-sensitivity C reactive protein (hs-CRP), on presentation, in the prediction of intravenous thrombolysis outcome in patients with ST-segment elevation myocardial infarction (STEMI).Prospective observational study in a tertiary referral centre.786 consecutive patients with STEMI, who received intravenous thrombolysis in the first 6 h from index pain.The incidence of failed thrombolysis and of cardiac death by 30 days. Failed thrombolysis was defined as the absence of abrupt and sustainedor =50% ST-segment recovery in the first 90 min after the initiation of intravenous thrombolysis.The incidence of failed thrombolysis and 30-day cardiac death was 57.4% and 11.8%, respectively. By multivariate logistic regression analysis according to tertiles of both cTnI (RR, 1.5; 95% CI 1.1 to 1.8, p = 0.004 for highest vs middle third; 2.2, 1.9 to 3.5, p0.001 for highest vs lowest third; 1.5, 1.2 to 1.8, p = 0.001 for middle vs lowest third) and hs-CRP (RR, 2.0, 95% CI, 1.6 to 2.2; p0.001 for highest vs middle third; 2.6, 2.1 to 3.5, p0.001 for highest vs lowest third; 1.3, 1.2 to 1.7, p = 0.02 for middle vs lowest third), were independently associated with failed thrombolysis. Moreover, by multivariate Cox regression analysis according to tertiles of both cTnI (HR 1.2, 95% CI 1.1 to 1.8, p = 0.03 for highest vs middle third; 1.5, 1.2 to 2.2, p = 0.004 for highest vs lowest third; 1.1, 0.6 to 1.4, p = 0.6 for middle vs lowest third) and hs-CRP (HR1.2, 95% CI 1.1 to 1.6, p = 0.04 for highest vs middle third; 1.7, 1.3 to 2.6, p = 0.001 for highest vs lowest third; 1.1, 0.9 to 2.1, p = 0.1 for middle vs lowest third), were independently related with an increased risk of 30-day cardiac death.High circulating levels of both cTnI and hs-CRP are related with an independent increased risk of intravenous thrombolysis failure and 30-day cardiac death in patients who received intravenous thrombolysis in the first 6 h of STEMI. |
| Databáze: | OpenAIRE |
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