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

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

[img] Text
Harada CardiovascRevascMed 2017.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (627kB) | Request a copy

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

UniBE Contributor:

Koskinas, Konstantinos; Räber, Lorenz; Hunziker, Lukas; Heg, Dierik Hans and 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:

24 Oct 2019 14:56

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

Actions (login required)

Edit item Edit item
Provide Feedback