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Short- and long-ter...
Short- and long-term risk stratification in acute coronary syndromes : the added value of quantitative ST-segment depression and multiple biomarkers
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Westerhout, Cynthia M. (författare)
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Fu, Yuling (författare)
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Lauer, Michael S. (författare)
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- James, Stefan, 1964- (författare)
- Uppsala universitet,Institutionen för medicinska vetenskaper,UCR
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Armstrong, Paul W. (författare)
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Al-Hattab, Eyad (författare)
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Califf, Robert M. (författare)
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Simoons, Maarten L. (författare)
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- Wallentin, Lars, 1943- (författare)
- Uppsala universitet,Institutionen för medicinska vetenskaper,UCR
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Boersma, Eric (författare)
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(creator_code:org_t)
- Elsevier BV, 2006
- 2006
- Engelska.
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Ingår i: Journal of the American College of Cardiology. - : Elsevier BV. - 0735-1097 .- 1558-3597. ; 48:5, s. 939-947
- Relaterad länk:
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https://doi.org/10.1...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
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- OBJECTIVES: The purpose of this study was to develop 30-day and 1-year risk stratification models for non-ST-segment elevation acute coronary syndrome (NSTE-ACS) patients that incorporate quantitative ST-segment depression and novel biomarkers. BACKGROUND: Several novel biomarkers have changed the risk profile of ACS; thus, the reassessment of traditional indicators such as ST-segment depression in this new context is warranted. METHODS: Multivariable logistic regression was used to identify significant predictors of 30-day death and death/myocardial infarction (MI) and 1-year mortality in 7,800 NSTE-ACS patients enrolled in the GUSTO-IV (Global Utilization of Strategies to Open Occluded Arteries-IV ACS) trial between 1998 and 2000. RESULTS: Among all other predictors, the degree of ST-segment depression had the highest prognostic value for 30-day death, 30-day death/MI, and 1-year death. Troponin T (TnT), creatinine clearance, N-terminal pro-brain natriuretic peptide (NT-proBNP), heart rate, and age were also highly influential on adverse outcomes. Unlike TnT and NT-proBNP, C-reactive protein was only predictive of long-term death. In contrast to mortality, the contribution of TnT to predicting 30-day death/MI increased, whereas NT-proBNP's role was attenuated. The discriminatory power was excellent (c-index [adjusted for over-optimism]: 0.82 [30-day death]; 0.72 [30-day death/MI]; 0.81 [1-year]). CONCLUSIONS: In this large contemporary study of NSTE-ACS patients, novel insights into risk stratification were observed-in particular, the utility of quantitative ST-segment depression and multiple biomarkers. Collection of these indicators in future NSTE-ACS populations is recommended to evaluate generalizability and clinical application of these findings.
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- MEDICINE
- MEDICIN
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Westerhout, Cynt ...
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Fu, Yuling
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Lauer, Michael S ...
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James, Stefan, 1 ...
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Armstrong, Paul ...
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Al-Hattab, Eyad
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Califf, Robert M ...
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Simoons, Maarten ...
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Wallentin, Lars, ...
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Boersma, Eric
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Uppsala universitet