Prognostic value of high sensitivity troponin T after ST-segment elevation myocardial infarction in the era of cardiac magnetic resonance imaging

European Heart Journal. Quality of Care & Clinical Outcomes
Tuan L NguyenLiza Thomas

Abstract

To determine if high sensitivity troponin T (hs-TnT) measurements performed during the 'plateau phase' of troponin release (≥48 h) following ST-segment elevation myocardial infarction (STEMI) can predict major adverse cardiovascular endpoints (MACE), and to evaluate its prognostic value compared with cardiac magnetic resonance imaging (CMRI) parameters. We prospectively recruited 201 first presentation STEMI patients. Serial hs-TnT levels were measured at admission, peak (highest), 24, 48 and 72 h. CMRI and transthoracic echocardiography were performed (4 days median) post-STEMI, evaluating infarct scar characteristics and left ventricular ejection fraction (LVEF). Associations were determined between hs-TnT levels and CMRI parameters early after STEMI with MACE (comprising mortality, re-infarction, new or worsening of heart failure, cerebrovascular accident, and sustained ventricular arrhythmias) at medium-term follow-up. After 602 days (median), 33 (17%) patients had MACE. Upper tertile hs-TnT levels at 48 and 72 h were associated with MACE (Kaplan-Meier P = 0.002 and P = 0.012, respectively). Multivariate Cox analyses, incorporating diabetes, CMRI scar size, LVEF and hs-TnT levels (applied at a single hs-TnT time point) show...Continue Reading

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Sep 23, 2014·Journal of the American College of Cardiology·Ingo EitelHolger Thiele

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Citations

Jul 21, 2020·European Heart Journal. Quality of Care & Clinical Outcomes·Anish NikhanjGavin Y Oudit
Jul 1, 2016·European Heart Journal. Quality of Care & Clinical Outcomes·Anoop S V Shah, Nicholas L Mills
Aug 15, 2020·Journal of the American College of Cardiology·Koen AmelootMarkus B Skrifvars

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