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Troponin-T and N-te...
Troponin-T and N-terminal pro-B-type natriuretic peptide predict mortality benefit from coronary revascularization in acute coronary syndromes : a GUSTO-IV substudy
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- James, Stefan K., 1964- (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)
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- Lindbäck, Johan (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)
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- Tilly, Johanna (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)
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- Siegbahn, Agneta, 1947- (author)
- Uppsala universitet,Institutionen för medicinska vetenskaper
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- Venge, Per (author)
- Uppsala universitet,Institutionen för medicinska vetenskaper
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Armstrong, Paul (author)
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Califf, Robert (author)
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Simoons, Maarten L. (author)
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- Wallentin, Lars, 1943- (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)
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- Lindahl, Bertil, 1957- (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)
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(creator_code:org_t)
- Elsevier BV, 2006
- 2006
- English.
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In: Journal of the American College of Cardiology. - : Elsevier BV. - 0735-1097 .- 1558-3597. ; 48:6, s. 1146-1154
- Related links:
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https://doi.org/10.1...
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https://urn.kb.se/re...
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Abstract
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- OBJECTIVES: This study was designed to evaluate biomarkers for selection of patients with non-ST-segment elevation acute coronary syndromes (ACS) that derive mortality benefit from revascularization. BACKGROUND: Biomarkers are essential for identification of patients at increased risk, which may be reduced by revascularization. METHODS: During the initial 30 days, 2,340 patients of 7,800 (30%) with non-ST-segment elevation ACS in the GUSTO (Global Utilization of Strategies To open Occluded arteries)-IV trial underwent coronary revascularization. The 1-year mortality was calculated in 30-day survivors stratified by status of revascularization and levels of biomarkers. A propensity score for receiving revascularization was constructed and included in a survival analysis that also included the time point of revascularization as a time-dependent covariate. RESULTS: Elevation of troponin-T or N-terminal pro-B-type natriuretic peptide (NT-proBNP) was associated with a high mortality. In patients with either or both of these markers elevated, a lower mortality following revascularization was observed. In contrast, patients without elevation of these markers had low 1-year mortality without any reduction in mortality following revascularization. In fact, in patients with normal levels of both troponin-T and NT-proBNP, a significant increase in 1-year mortality after revascularization was observed. Elevation of C-reactive protein, interleukin-6, creatinine clearance, and ST-segment depression was also related to a higher mortality. However, independent of these markers, mortality was lower after revascularization. CONCLUSIONS: Markers of troponin-T and NT-proBNP not only assist in risk stratification of patients with non-ST-segment elevation ACS but also appear to identify patients who have a reduced mortality associated with early coronary revascularization.
Keyword
- MEDICINE
- MEDICIN
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- ref (subject category)
- art (subject category)
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James, Stefan K. ...
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Lindbäck, Johan
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Tilly, Johanna
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Siegbahn, Agneta ...
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Venge, Per
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Armstrong, Paul
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show more...
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Califf, Robert
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Simoons, Maarten ...
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Wallentin, Lars, ...
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Lindahl, Bertil, ...
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Journal of the A ...
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Uppsala University