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Postprocedural high-sensitivity troponin T and prognosis in patients with non-ST-segment elevation myocardial infarction treated with early percutaneous coronary intervention.

Authors :
Harada, Yukinori
Koskinas, Konstantinos C.
Ndrepepa, Gjin
Räber, Lorenz
Braun, Siegmund
Zanchin, Thomas
Kufner, Sebastian
Hunziker, Lukas
Byrne, Robert A.
Heg, Dik
Kastrati, Adnan
Windecker, Stephan
Source :
Cardiovascular Revascularization Medicine. Jul2018 Part A, Vol. 19 Issue 5, p480-486. 7p.
Publication Year :
2018

Abstract

<bold>Background: </bold>The association of postprocedural high-sensitivity troponin T (hs-TnT) with prognosis of non-ST-segment elevation myocardial infarction (NSTEMI) patients is incompletely investigated.<bold>Aim: </bold>To assess the prognostic value of hs-TnT in NSTEMI patients undergoing early percutaneous coronary intervention (PCI).<bold>Methods: </bold>This study included 3783 patients with NSTEMI undergoing early PCI. Preprocedural and peak postprocedural hs-TnT was measured. Patients were divided into 3 groups: a group with postprocedural hs-TnT in the 1st tertile (hs-TnT <105ng/L; n=1264), a group with postprocedural hs-TnT in the 2nd tertile (hs-TnT ≥105ng/L to 470ng/L; n=1258) and a group with postprocedural hs-TnT in the 3rd tertile (hs-TnT >470ng/L; n=1261). The primary outcome was 1-year all-cause mortality.<bold>Results: </bold>Overall, there were 299 deaths: 59 (5.5%), 98 (8.2%) and 142 deaths (12.6%) among patients of the 1st, 2nd and 3rd postprocedural hs-TnT tertiles (unadjusted hazard ratio [HR]=1.65, 95% confidence interval [CI] 1.20 to 2.67; P=0.002 for tertile 2 vs tertile 1 and unadjusted HR=2.41 [1.79-3.25]; P<0.001 for tertile 3 vs tertile 1). After adjustment postprocedural hs-TnT was independently associated with the risk of all-cause mortality (adjusted [HR]=1.22 [1.13-1.33], P<0.001 for 1 unit higher log hs-TnT). Postprocedural hs-TnT improved the risk prediction of the model of all-cause mortality (the C statistic of the model without [with baseline variables only] and with incorporation of postprocedural hs-TnT was 0.759 [0.732-0.782] and 0.772 [0.746-0.794], respectively; P<0.001).<bold>Conclusions: </bold>In patients with NSTEMI undergoing early PCI, postprocedural hs-TnT is independently associated with increased risk of mortality up to 1year after PCI. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
15538389
Volume :
19
Issue :
5
Database :
Academic Search Index
Journal :
Cardiovascular Revascularization Medicine
Publication Type :
Academic Journal
Accession number :
130357402
Full Text :
https://doi.org/10.1016/j.carrev.2017.11.010