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Usefulness of bioma...
Usefulness of biomarkers for predicting long-term mortality in patients with diabetes mellitus and non-ST-elevation acute coronary syndromes (A GUSTO IV substudy)
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- James, Stefan K., 1964- (author)
- Uppsala universitet,Kardiologi
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- Lindahl, Bertil, 1957- (author)
- Uppsala universitet,Kardiologi
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Timmer, Jorik R. (author)
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Ottervanger, Jan Paul (author)
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- Siegbahn, Agneta, 1947- (author)
- Uppsala universitet,Klinisk kemi
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- Stridsberg, Mats (author)
- Uppsala universitet,Klinisk kemi,Biokemisk endokrinologi
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Armstrong, Paul (author)
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Califf, Robert (author)
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- Wallentin, Lars, 1943- (author)
- Uppsala universitet,Kardiologi
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Simoons, Maarten L. (author)
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(creator_code:org_t)
- Elsevier BV, 2006
- 2006
- English.
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In: American Journal of Cardiology. - : Elsevier BV. - 0002-9149 .- 1879-1913. ; 97:2, s. 167-172
- Related links:
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http://www.ncbi.nlm....
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Subject headings
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- The present study evaluated whether biomarkers of ischemia, inflammation, myocardial damage, and dysfunction are equally useful in patients who have diabetes mellitus (DM) for prediction of cardiac events in non-ST-elevation acute coronary syndrome (ACS). DM was present in 1,677 of 7,800 patients (21.5%) who had non-ST-elevation ACS and were included in the Fourth Global Utilization of Strategies To Open Occluded Arteries (GUSTO IV) trial. Creatinine, N-terminal pro-B-type natriuretic peptide (NT-pro-BNP), troponin T, C-reactive protein, and interleukin-6 were analyzed in serum samples that were obtained at a median of 9.5 hours from symptom onset. One-year mortality rates were 13.5% among patients who had DM (n = 227) and 6.9% among those who did not (n = 418, p < 0.001). The median level of NT-pro-BNP was 2 times as high in patients who had DM, whereas troponin T levels did not differ by DM status. Mortality increased with ascending quartiles of NT-pro-BNP, with 1-year mortality rates of 3.9% (n = 11) in the bottom quartile and 29% (n = 103) in the top quartile. In multivariable analyses, factors that were predictive of 1-year mortality in patients who did not have DM were also significant for those who did. Presence of ST depression > 0.5 mm had the highest odds ratio of 2.3 (95% confidence interval 1.2 to 4.6). NT-pro-BNP levels > 669 ng/L (odds ratio 2.0, 95% confidence interval 1.1 to 3.6) and interleukin-6 levels > 10 ng/L (odds ratio 1.9, 95% confidence interval 1.2 to 3.0) were significant biomarker predictors. In conclusion, DM confers a high long-term mortality in non-ST-elevation ACS. Despite a larger proportion of ST depression and increased levels of NT-pro-BNP and interleukin-6 at admission, these factors provide independent prognostic information that may improve risk stratification and guidance of treatment.
Keyword
- Aged
- Biological Markers
- C-Reactive Protein
- Diabetes Mellitus/blood/*mortality
- Diabetic Angiopathies/blood/*mortality
- Female
- Humans
- Interleukin-6/blood
- Logistic Models
- Male
- Middle Aged
- Myocardial Infarction/blood/*mortality
- Natriuretic Peptide; Brain/blood
- Peptide Fragments/blood
- Prognosis
- Retrospective Studies
- Risk Assessment
- Survival Analysis
- Syndrome
- Troponin T
- MEDICINE
- MEDICIN
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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James, Stefan K. ...
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Lindahl, Bertil, ...
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Timmer, Jorik R.
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Ottervanger, Jan ...
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Siegbahn, Agneta ...
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Stridsberg, Mats
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show more...
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Armstrong, Paul
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Califf, Robert
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Wallentin, Lars, ...
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Simoons, Maarten ...
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American Journal ...
- By the university
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Uppsala University