Skip to main content

Peak and Fixed-Time High-Sensitive Troponin for Prediction of
Infarct Size, Impaired Left Ventricular Function, and Adverse
Outcomes in Patients With First ST-Segment Elevation Myocardial
Infarction Receiving Percutaneous Coronary Intervention

مؤلف البحث
Helèn Boden, Tarek A.N. Ahmed, Matthijs A. Velders, Bas L. van der Hoeven, Georgette E. Hoogslag, Marianne Bootsma, Saskia le Cessie, Christa M. Cobbaert, Victoria Delgado, Arnoud van der Laarse, and Martin J. Schalij,
مجلة البحث
The American Journal of Cardiology
المشارك في البحث
تصنيف البحث
1
عدد البحث
Vol.111, No,10
سنة البحث
2013
صفحات البحث
PP. 1387-1393
ملخص البحث

The clinical use of advanced imaging modalities for early determination of infarct size and
prognosis is limited. As a specific indicator of myocardial necrosis, cardiac troponin
T (cTnT) can be used as a surrogate measure for this purpose. The present study sought to
investigate the use of peak and serial 6-hour fixed-time high-sensitive (hs) cTnT for estimation
of infarct size, left ventricular (LV) function, and prognosis in consecutive patients
with ST-segment elevation myocardial infarction. The infarct size was expressed as the
48-hour cumulative creatine kinase release. LV function at 3 months was assessed using the
echocardiographic wall motion score index and LV ejection fraction using radionuclide
ventriculography. Adverse outcomes, comprising all-cause death, implantable cardioverterdefibrillator
implantation, or hospitalization for heart failure, were recorded at 1 year of
follow-up. In 188 patients, the peak and all fixed-time values correlated significantly with
the 48-hour cumulative creatine kinase release, wall motion score index, and LV ejection
fraction. The hs-cTnT value at 24 hours demonstrated the greatest correlation (r [ 0.86,
r [ 0.47, and r [ L0.59, respectively; p <0.001 for all). In the multivariate regression
models adjusted for the clinical parameters, almost all were independently associated with
the 48-hour cumulative creatine kinase release, wall motion score index, and LV ejection
fraction, with the hs-cTnT value at 24 hours having the largest effect. Moreover, all cTnT
values independently predicted adverse outcomes, again, with the hs-cTnT value at
24 hours showing the largest influence (hazard ratio 3.77, 95% confidence interval 2.12 to
6.73, p <0.001). In conclusion, not only peak, but all fixed-time hs-cTnT values were
associated with infarct size, LV function at 3 months, and adverse outcomes 1 year after STsegment
elevation myocardial infarction. The value 24 hours after the onset of symptoms
had the closest associations with all outcomes. Therefore, serial sampling for a peak value
might be redundant.