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 (2018). Postprocedural high-sensitivity troponin T and prognosis in patients with non-ST-segment elevation myocardial infarction treated with early percutaneous coronary intervention. Cardiovascular revascularization medicine, 19(5 Pt A), pp. 480-486. Elsevier 10.1016/j.carrev.2017.11.010
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BACKGROUND
The association of postprocedural high-sensitivity troponin T (hs-TnT) with prognosis of non-ST-segment elevation myocardial infarction (NSTEMI) patients is incompletely investigated.
AIM
To assess the prognostic value of hs-TnT in NSTEMI patients undergoing early percutaneous coronary intervention (PCI).
METHODS
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.
RESULTS
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).
CONCLUSIONS
In patients with NSTEMI undergoing early PCI, postprocedural hs-TnT is independently associated with increased risk of mortality up to 1year after PCI.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology 04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM) |
UniBE Contributor: |
Koskinas, Konstantinos, Räber, Lorenz, Hunziker Munsch, Lukas Christoph, Heg, Dierik Hans, Windecker, Stephan |
Subjects: |
600 Technology > 610 Medicine & health 300 Social sciences, sociology & anthropology > 360 Social problems & social services |
ISSN: |
1553-8389 |
Publisher: |
Elsevier |
Language: |
English |
Submitter: |
Tanya Karrer |
Date Deposited: |
15 Feb 2018 11:10 |
Last Modified: |
02 Mar 2023 23:30 |
Publisher DOI: |
10.1016/j.carrev.2017.11.010 |
PubMed ID: |
29292015 |
Additional Information: |
Harada and Koskinas contributed equally to this work |
Uncontrolled Keywords: |
High-sensitivity troponin T Mortality Non-ST-segment elevation myocardial infarction Percutaneous coronary intervention |
BORIS DOI: |
10.7892/boris.110690 |
URI: |
https://boris.unibe.ch/id/eprint/110690 |
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