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The prognostic and ...
The prognostic and therapeutic implications of increased troponin T levels and ST depression in unstable coronary artery disease : the FRISC II invasive troponin T electrocardiogram substudy
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Diderholm, Erik (författare)
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- Andrén, Bertil (författare)
- Uppsala universitet,Institutionen för medicinska vetenskaper,Kardiologi
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- Frostfeldt, Gunnar (författare)
- Uppsala universitet,Institutionen för medicinska vetenskaper,Kardiologi
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Genberg, Margareta (författare)
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Jernberg, Tomas (författare)
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- Lagerqvist, Bo (författare)
- Uppsala universitet,Institutionen för medicinska vetenskaper,Kardiologi
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- Lindahl, Bertil (författare)
- Uppsala universitet,Institutionen för medicinska vetenskaper,Kardiologi
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Venge, Per (författare)
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- Wallentin, Lars (författare)
- Uppsala universitet,Institutionen för medicinska vetenskaper,Kardiologi
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(creator_code:org_t)
- Elsevier BV, 2002
- 2002
- Engelska.
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Ingår i: American Heart Journal. - : Elsevier BV. - 0002-8703 .- 1097-6744. ; 143:5, s. 760-767
- Relaterad länk:
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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
Ämnesord
Stäng
- BACKGROUND: In unstable coronary artery disease, both increased troponin T level and occurrence of ST-segment depression are associated with a worse prognosis. In the Fast Revascularisation in InStability in Coronary disease trial II invasive study, we evaluated whether the troponin T level, alone and combined with ST depression, identified more severe coronary artery disease or a greater efficacy of an early invasive strategy. METHODS: In the study, 2457 patients with unstable coronary artery disease were randomized to early invasive or noninvasive strategy. Troponin T value and admission electrocardiogram results were available in 2286 patients. RESULTS: In the noninvasive cohort, death or myocardial infarction occurred in 16.6% with troponin T level > or =0.03 microg/L versus 8.5% with troponin T level < 0.03 microg/L (P <.001). In the invasive group, 49% of patients with both ST depression and troponin T level > or =0.03 microg/L had 3-vessel or left main disease compared with 17% if neither finding was present (P <.001). The invasive strategy reduced death/myocardial infarction at 12 months in the cohort with both ST depression and troponin T level > or =0.03 microg/L from 22.1% to 13.2% (risk ratio, 0.60; 95% confidence interval, 0.43 to 0.82; P =.001). In the cohort with either ST depression or troponin T level > or =0.03 microg/L or neither of these findings, the absolute gain of the invasive strategy was smaller and more uncertain. CONCLUSION: Patients with unstable coronary artery disease with the combination of troponin T level > or =0.03 microg/L and ST depression have a poor prognosis and, in half of the cases, 3-vessel or left main disease. In these patients, an early invasive strategy will substantially reduce death/myocardial infarction.
Nyckelord
- Aged
- Biological Markers/blood
- Cohort Studies
- Confidence Intervals
- Coronary Disease/*blood/*physiopathology/therapy
- Electrocardiography
- Female
- Humans
- Male
- Middle Aged
- Myocardial Infarction/etiology/mortality
- Prognosis
- Regression Analysis
- Research Support; Non-U.S. Gov't
- Tedelparin/therapeutic use
- Troponin T/*blood
- MEDICINE
- MEDICIN
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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