Clinical significance of a single measurement of troponin-I and C-reactive protein at admission in 1773 consecutive patients with acute coronary syndromes

American Heart Journal
Luigi OltronaItalian Working Group on Atherosclerosis, Thrombosis, and Vascular Biology and the Associazione Nazionale Medici Cardiologi

Abstract

The clinical significance of biochemical markers of myocardial damage or inflammation has not been prospectively established in populations representing the whole spectrum of acute coronary syndromes. We investigated whether the elevation of these biomarkers at admission has a prognostic value that is independent and incremental to baseline clinical variables and quantitative electrocardiographic ischemia. We measured blood levels of cardiac troponin I (cTnI) and C-reactive protein (CRP) in 1773 consecutive patients admitted to 31 Italian coronary care units within 12 hours from an episode of acute coronary syndrome. Primary and secondary outcomes were (1) 30-day incidence of death or nonfatal (re)infarction and (2) death alone. In a multivariate model, cTnI was independently associated with the risk of death or (re)infarction (OR, 1.8; 95% CI, 1.2 to 2.6; P =.002) and death (OR, 2.2; 95% CI, 1.4 to 3.4; P <.001), whereas CRP was of borderline significance for the primary outcome but was associated with death (OR, 1.4; 95% CI, 1.0 to 2.1; P =.06, and OR, 1.7; 95% CI, 1.1 to 2.6; P =.01, respectively). However, the inclusion of the biomarkers did not increase the prognostic capacity of the clinical risk model (C-index of both mo...Continue Reading

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Citations

Aug 1, 2006·Surgical Infections·Steven C CunninghamLena M Napolitano
Feb 3, 2007·International Heart Journal·Olivera DimitrijevićNada Majkić Singh
Jul 11, 2006·Current Cardiology Reports·Raphael See, James A de Lemos
Sep 4, 2007·Progress in Cardiovascular Diseases·Sachin Gupta, James A de Lemos
Oct 10, 2009·Clinical Cardiology·Flávia K BorgesCarísi A Polanczyk
Sep 30, 2006·Clinical Cardiology·Euler R E ManentiCarisi A Polanczyk
Sep 22, 2012·JACC. Cardiovascular Interventions·Stefano SavonittoUNKNOWN Italian Elderly ACS Trial Investigators
Oct 26, 2016·Biomedicine & Pharmacotherapy = Biomédecine & Pharmacothérapie·Mehrdad Namdari, Ali Eatemadi
Oct 26, 2006·Circulation Journal : Official Journal of the Japanese Circulation Society·Hyungseop KimWee-Hyun Park
Mar 23, 2010·Coronary Artery Disease·Raquel Melchior RomanCarisi Anne Polanczyk
Mar 17, 2020·European Heart Journal·Patrick R LawlerPaul M Ridker
Jul 6, 2020·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Ryan T SlessGerry Fahy
May 1, 2021·Journal of Clinical Medicine·Francesco GiallauriaCarlo Vigorito

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