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, J. Patrick; Cassese, Salvatore; Fusaro, Massimiliano; Laugwitz, Karl‐Ludwig; Schunkert, Heribert; Kastrati, Adnan

doi:10.1016/j.jjcc.2018.02.014

Cited by 17 publications

(17 citation statements)

References 36 publications

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“…Therefore, the use of a more objective clinical tool to estimate the duration from symptom onset to presentation is desirable. 25,26 Third, although we were not able to assess symptom presentation using an alternative definition, 27 the definition of atypical symptoms varies between studies and there is no general consensus as to their assessment in patients with suspected AMI. Thus, more data are needed to examine this issue further.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Door-to-Balloon Time and 30-Day Mortality According to Symptom Presentation in Patients With Acute Myocardial Infarction

et al. 2021

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Background: We hypothesized that symptom presentation in patients with acute myocardial infarction (AMI) may affect their management and subsequent outcome. Methods and Results: Using Rural AMI Registry data, 1,337 consecutive patients with AMI who underwent percutaneous coronary intervention were analyzed. Typical symptoms were defined as any symptoms of chest pain or pressure due to myocardial ischemia. We considered the specific symptoms of dyspnea, nausea, or vomiting as atypical symptoms. The primary outcome was 30-day mortality. There were 150 (11.2%) and 1,187 (88.8%) patients who presented with atypical and typical symptoms, respectively. Those who presented with atypical symptoms were significantly older (mean [±SD] age 74±12 vs. 68±13 years; P<0.001) and had a higher Killip class (46.7% vs. 21.8%; P<0.001) than patients presenting with typical symptoms. The prevalence of door-to-balloon time of ≤90 min was significantly lower in patients with atypical than typical symptoms (40.0% vs. 66.3%; P<0.001). At 30 days, there were 55 incidents of all-cause death. Multivariate Cox proportional hazards regression analysis revealed that symptom presentation was associated with 30-day mortality (hazard ratio 2.33; 95% confidence interval 1.20–4.38; P<0.05). Conclusions: Atypical symptoms in patients with AMI are less likely to lead to timely reperfusion and are associated with increased risk of 30-day mortality.

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Section: Discussionmentioning

confidence: 99%

Comparison of Door-to-Balloon Time and 30-Day Mortality According to Symptom Presentation in Patients With Acute Myocardial Infarction

et al. 2021

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“…Among factors that can be used for risk stratification after AMI, the following play an important role: elevated levels of troponin T or I (TnT or TnI) [3, 4] and a combination of (A) increased TnT and CRP plasma levels, (B) increased levels of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) with LVEF < 40% [4–7], and (C) decreased clearance of creatinine (with a reduced LVEF) [8].…”

Section: Introductionmentioning

confidence: 99%

Prognostic Value of MicroRNAs in Patients after Myocardial Infarction: A Substudy of PRAGUE-18

et al. 2019

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Background The evaluation of the long-term risk of major adverse cardiovascular events and cardiac death in patients after acute myocardial infarction (AMI) is an established clinical process. Laboratory markers may significantly help with the risk stratification of these patients. Our objective was to find the relation of selected microRNAs to the standard markers of AMI and determine if these microRNAs can be used to identify patients at increased risk. Methods Selected microRNAs (miR-1, miR-133a, and miR-499) were measured in a cohort of 122 patients from the PRAGUE-18 study (ticagrelor vs. prasugrel in AMI treated with primary percutaneous coronary intervention (pPCI)). The cohort was split into two subgroups: 116 patients who did not die (survivors) and 6 patients who died (nonsurvivors) during the 365-day period after AMI. Plasma levels of selected circulating miRNAs were then assessed in combination with high-sensitivity cardiac troponin T (hsTnT) and N-terminal probrain natriuretic peptide (NT-proBNP). Results miR-1, miR-133a, and miR-499 correlated positively with NT-proBNP and hsTnT 24 hours after admission and negatively with left ventricular ejection fraction (LVEF). Both miR-1 and miR-133a positively correlated with hsTnT at admission. Median relative levels of all selected miRNAs were higher in the subgroup of nonsurvivors (N = 6) in comparison with survivors (N = 116), but the difference did not reach statistical significance. All patients in the nonsurvivor subgroup had miR-499 and NT-proBNP levels above the cut-off values (891.5 ng/L for NT-proBNP and 0.088 for miR-499), whereas in the survivor subgroup, only 28.4% of patients were above the cut-off values (p = 0.001). Conclusions Statistically significant correlation was found between miR-1, miR-133a, and miR-499 and hsTnT, NT-proBNP, and LVEF. In addition, this analysis suggests that plasma levels of circulating miR-499 could contribute to the identification of patients at increased risk of death during the first year after AMI, especially when combined with NT-proBNP levels.

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“…Both clinical HF and LVSD were independently associated with adverse clinical events, suggesting that a broader range of HF phenotypes affect the post-procedural outcome. PCI in patients with LVSD is known to be associated with increased long-term mortality [2][3][4][5]9], despite significant progress in percutaneous revascularization [10][11][12]17,18]. In the British Cardiovascular Intervention Society data set, worsening LV systolic function was associated with worse long-term outcomes [3].…”

Section: Discussionmentioning

confidence: 99%

Independent and cumulative association of clinical and morphological heart failure with long-term outcome after percutaneous coronary intervention

Kimura

Kohno

Sawano

et al. 2021

Journal of Cardiology

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Heart failure (HF) is associated with high rates of mortality, morbidity, and readmission; it puts an increased economic burden on the healthcare system [1]. It is also an established risk factor for adverse post-procedural outcomes after revascularization [2-6]. Patients with HF typically present with signs and symptoms of congestion, which require therapeutic interventions. However, accumulating evidence has shown that HF patients can be categorized into various stages; with the development of imaging modalities, morphological left ventricular systolic dysfunction (LVSD) in the absence of overt clinical symptoms has been

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

Abstract: In conclusion, admission or peak postprocedural hs-cTnT is independently associated with the risk for 3-year mortality in patients with STEMI undergoing PPCI.

Cited by 17 publications

References 36 publications

Comparison of Door-to-Balloon Time and 30-Day Mortality According to Symptom Presentation in Patients With Acute Myocardial Infarction

Comparison of Door-to-Balloon Time and 30-Day Mortality According to Symptom Presentation in Patients With Acute Myocardial Infarction

Prognostic Value of MicroRNAs in Patients after Myocardial Infarction: A Substudy of PRAGUE-18

Independent and cumulative association of clinical and morphological heart failure with long-term outcome after percutaneous coronary intervention

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