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Usefulness of High ...
Usefulness of High Sensitivity Troponin T to Predict Long-Term Left Ventricular Dysfunction After ST-Elevation Myocardial Infarction
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- Mohammad, Moman A. (author)
- Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Molekylär kardiologi,Forskargrupper vid Lunds universitet,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Molecular Cardiology,Lund University Research Groups,Skåne University Hospital
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- Koul, Sasha (author)
- Lund University,Lunds universitet,Molekylär kardiologi,Forskargrupper vid Lunds universitet,Molecular Cardiology,Lund University Research Groups,Skåne University Hospital
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- Lønborg, Jacob Thomsen (author)
- Copenhagen University Hospital
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- Nepper-Christensen, Lars (author)
- Copenhagen University Hospital
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- Høfsten, Dan E. (author)
- Copenhagen University Hospital
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- Ahtarovski, Kiril A. (author)
- Copenhagen University Hospital
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- Bang, Lia E. (author)
- Copenhagen University Hospital
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- Helqvist, Steffen (author)
- Copenhagen University Hospital
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- Kyhl, Kasper (author)
- Copenhagen University Hospital
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- Køber, Lars (author)
- Copenhagen University Hospital
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- Kelbæk, Henning (author)
- Zealand University Hospital
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- Vejlstrup, Niels (author)
- Copenhagen University Hospital
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- Holmvang, Lene (author)
- Copenhagen University Hospital
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- Schoos, Mikkel Malby (author)
- Copenhagen University Hospital
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- Göransson, Christoffer (author)
- Copenhagen University Hospital
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- Engstrøm, Thomas (author)
- 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,Copenhagen University Hospital
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- Erlinge, David (author)
- Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Molekylär kardiologi,Forskargrupper vid Lunds universitet,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Molecular Cardiology,Lund University Research Groups
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(creator_code:org_t)
- Elsevier BV, 2020
- 2020
- English 6 s.
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In: American Journal of Cardiology. - : Elsevier BV. - 0002-9149. ; 134, s. 8-13
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Abstract
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- Guidelines recommend the use of transthoracic echocardiography (TTE) and clinical scores to risk stratify patients after ST-elevation myocardial infarction (STEMI). High sensitivity troponin T (hs-cTnT) is predictive of outcome after STEMI but the predictive value of hs-cTnT relative to other risk assessment tools has not been established. We aimed to compare the predictive value of hs-cTnT to other risk assessment tools in patients with STEMI. A subset of 578 patients with STEMI were included in this post-hoc study from the Third DANish Study of Optimal Acute Treatment of Patients with ST-segment Elevation Myocardial Infarction trial. Patients underwent cardiac magnetic resonance imaging (CMR) during index hospitalization as well as TTE at 1 year after their STEMI. The predictive value of hs-cTnT was compared with CKMB, infarct size (IS)/left ventricular ejection fraction (LVEF) assessed with CMR, LVEF assessed at discharge with TTE and the Global Registry of Acute Coronary Events (GRACE) and Thrombolysis in Myocardial Infarction (TIMI) risk-scores. The primary outcome was LV systolic dysfunction defined as LVEF ≤40% after 1 year on TTE. The area under the receiver operating characteristic curve analyses showed no significant difference between hs-cTnT and early CMR-assessed IS or LVEF in predicting subsequent LVEF ≤40%. Area under the curve for hs-cTnT was 0.82, 0.85 for IS (p = 0.22), and 0.87 for LVEF (p = 0.23). For predischarge TTE-assessed LVEF, the value was 0.85 (p = 0.45), 0.63 for creatine kinase-MB (p <0.001), 0.61 for the GRACE score (p <0.001), and 0.70 for the TIMI score (p = 0.02). A peak hs-cTnT value <3,500 ng/L ruled out LVEF ≤40% with probability of 98%. In conclusion, in patients presenting with STEMI undergoing PCI, hs-cTnT level strongly predicted long-term LV dysfunction and could be used as a clinical risk stratification tool to identify patients at high risk of progressing to LV dysfunction due to its general availability and high-predictive accuracy.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Publication and Content Type
- art (subject category)
- ref (subject category)
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- By the author/editor
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Mohammad, Moman ...
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Koul, Sasha
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Lønborg, Jacob T ...
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Nepper-Christens ...
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Høfsten, Dan E.
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Ahtarovski, Kiri ...
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show more...
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Bang, Lia E.
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Helqvist, Steffe ...
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Kyhl, Kasper
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Køber, Lars
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Kelbæk, Henning
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Vejlstrup, Niels
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Holmvang, Lene
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Schoos, Mikkel M ...
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Göransson, Chris ...
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Engstrøm, Thomas
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Erlinge, David
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
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American Journal ...
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Lund University