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  • Mohammad, Moman A.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 (author)

Usefulness of High Sensitivity Troponin T to Predict Long-Term Left Ventricular Dysfunction After ST-Elevation Myocardial Infarction

  • Article/chapterEnglish2020

Publisher, publication year, extent ...

  • Elsevier BV,2020
  • 6 s.

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  • LIBRIS-ID:oai:lup.lub.lu.se:67795156-136f-4f22-a43d-b305e2a1aa00
  • https://lup.lub.lu.se/record/67795156-136f-4f22-a43d-b305e2a1aa00URI
  • https://doi.org/10.1016/j.amjcard.2020.07.060DOI

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  • Language:English
  • Summary in:English

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  • Subject category:art swepub-publicationtype
  • Subject category:ref swepub-contenttype

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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.

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  • Koul, SashaLund University,Lunds universitet,Molekylär kardiologi,Forskargrupper vid Lunds universitet,Molecular Cardiology,Lund University Research Groups,Skåne University Hospital(Swepub:lu)med-sku (author)
  • Lønborg, Jacob ThomsenCopenhagen University Hospital (author)
  • Nepper-Christensen, LarsCopenhagen University Hospital (author)
  • Høfsten, Dan E.Copenhagen University Hospital (author)
  • Ahtarovski, Kiril A.Copenhagen University Hospital (author)
  • Bang, Lia E.Copenhagen University Hospital (author)
  • Helqvist, SteffenCopenhagen University Hospital (author)
  • Kyhl, KasperCopenhagen University Hospital (author)
  • Køber, LarsCopenhagen University Hospital (author)
  • Kelbæk, HenningZealand University Hospital (author)
  • Vejlstrup, NielsCopenhagen University Hospital (author)
  • Holmvang, LeneCopenhagen University Hospital (author)
  • Schoos, Mikkel MalbyCopenhagen University Hospital (author)
  • Göransson, ChristofferCopenhagen University Hospital (author)
  • Engstrøm, ThomasLund 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(Swepub:lu)th4331en (author)
  • Erlinge, DavidLund 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(Swepub:lu)kard-der (author)
  • KardiologiSektion II (creator_code:org_t)

Related titles

  • In:American Journal of Cardiology: Elsevier BV134, s. 8-130002-9149

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