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High-sensitivity tr...
High-sensitivity troponin-T as a prognostic marker after out-of-hospital cardiac arrest – A targeted temperature management (TTM) trial substudy
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- Gilje, Patrik (författare)
- Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine
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- Koul, Sasha (författare)
- Lund University,Lunds universitet,Molekylär kardiologi,Forskargrupper vid Lunds universitet,Molecular Cardiology,Lund University Research Groups
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- Thomsen, Jakob Hartvig (författare)
- Copenhagen University Hospital
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- Devaux, Yvan (författare)
- Luxembourg Institute of Health
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- Friberg, Hans (författare)
- Lund University,Lunds universitet,Anestesiologi och intensivvård,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Anesthesiology and Intensive Care,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
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- Kuiper, Michael (författare)
- Medical Center Leeuwarden
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- Horn, Janneke (författare)
- Academic Medical Center of University of Amsterdam (AMC)
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- Nielsen, Niklas (författare)
- Helsingborg Hospital
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- Pellis, Tomasso (författare)
- Santa Maria degli Angeli Hospital
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- Stammet, Pascal (författare)
- Centre Hospitalier de Luxembourg
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- Wise, Matthew P. (författare)
- University Hospital of Wales
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- Kjaergaard, Jesper (författare)
- Copenhagen University Hospital
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- Hassager, Christian (författare)
- Copenhagen University Hospital
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- Erlinge, David (författare)
- Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine
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(creator_code:org_t)
- Elsevier BV, 2016
- 2016
- Engelska 6 s.
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Ingår i: Resuscitation. - : Elsevier BV. - 0300-9572. ; 107, s. 156-161
- Relaterad länk:
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https://portal.resea... (primary) (free)
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http://dx.doi.org/10...
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
Ämnesord
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- Aim of the study Predicting outcome of unconscious patients after successful resuscitation is challenging and better prognostic markers are highly needed. Ischemic heart disease is a common cause of out-of-hospital cardiac arrest (OHCA). Whether or not high-sensitivity troponin T (hs-TnT) is a prognostic marker among survivors of OHCA with both ischemic and non-ischemic aetiologies remains to be determined. We sought to evaluate the ability of hs-TnT to prognosticate all-cause mortality, death due to cardiovascular causes or multi-organ failure and death due to cerebral causes after OHCA. The influence of the level of target temperature management on hs-TnT as a marker of infarct size was also assessed. Methods A total of 699 patients from the targeted temperature management (TTM) trial were included and hs-TnT was analyzed in blood samples from 24, 48 and 72 h after return of spontaneous circulation (ROSC). The endpoints were 180 day all-cause mortality, death due to cardiovascular causes or multi-organ failure and death due to cerebral causes. Subgroups based on the initial ECG after ROSC (STEMI vs all other ECG presentations) were analyzed. Results Hs-TnT was independently associated with all-cause mortality which was driven by death due to cardiovascular causes or multi-organ failure and not cerebral causes (at 48 h: OR 1.10, CI 1.01–1.20, p < 0.05). Hs-TnT was also an independent predictor of death due to cardiovascular causes or multi-organ failure (at 48 h: OR 1.13, CI 1.01–1.26, p < 0.05). In patients with STEMI, hs-TnT was independently associated with death due to cardiovascular causes or multi-organ failure (at 48 h: OR 1.47, CI 1.10–1.95, p < 0.01). Targeted temperature management at 33 °C was not associated with hs-TnT compared to 36 °C. Conclusions After OHCA due to both ischemic and non-ischemic causes, hs-TnT is an independent marker of both all-cause mortality and death due to cardiovascular causes or multi-organ failure. Targeted temperature management at 33 °C did not reduce hs-TnT compared to 36 °C. Hs-TnT may be a marker of poor prognosis after OHCA and this should be taken into consideration in patients that present with high troponin levels. Trial registration The TTM-trial is registered and accessible at Clinicaltrials.gov (identifier: NCT01020916).
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- High-sensitivity troponin T
- Hypothermia
- Out-of-hospital cardiac arrest
- Prognosis
- TTM-trial
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Till lärosätets databas
- Av författaren/redakt...
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Gilje, Patrik
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Koul, Sasha
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Thomsen, Jakob H ...
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Devaux, Yvan
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Friberg, Hans
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Kuiper, Michael
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Horn, Janneke
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Nielsen, Niklas
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Pellis, Tomasso
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Stammet, Pascal
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Wise, Matthew P.
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Kjaergaard, Jesp ...
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Hassager, Christ ...
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Erlinge, David
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Kardiologi
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Resuscitation
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Lunds universitet