Prognostic Value of New-Generation Troponins in -Segment-Elevation Myocardial Infarction in the Modern Era : The - Study
Cediel, Germán (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Rueda, Ferran (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Garcia Garcia, Cosme (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Oliveras, Teresa (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Labata, Carlos (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Serra Flores, Jordi (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Núñez, Julio (Universitat de València)
Bodi, Vicente (Universitat de València)
Ferrer Massot, Marc (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Lupón, Josep (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Bayés-Genís, Antoni (Universitat Autònoma de Barcelona. Departament de Medicina)

Date:	2017
Abstract:	In -segment-elevation myocardial infarction (), troponins are not needed for diagnosis: symptoms and data are sufficient to activate percutaneous coronary intervention. This study explored the prognostic value of new-generation troponins in a real-life cohort contemporarily treated for . We studied 1260 consecutive patients with primary treated with percutaneous coronary intervention between February 22, 2011, and August 31, 2015. We collected data on clinical characteristics and major adverse cardiovascular and cerebrovascular events () at 30 days and 1 year. Peak high-sensitivity troponin T and sensitive-contemporary troponin I levels were recorded. s occurred in 75 patients (6. 1%) by day 30 and in 124 patients (10. 8%) between day 31 and 1 year. A short-term (0-30 days) multivariable Cox regression analysis revealed that age, Killip-Kimball class, and left ventricular ejection fraction were independent predictors of s. In adjusted analysis, peak high-sensitivity troponin T and sensitive-contemporary troponin I were not significant (hazard ratio, 1. 23 [95% confidence interval, 0. 98-1. 54] [ P =0. 071]; and hazard ratio, 1. 15 [95% confidence interval, 0. 93-1. 43] [ P =0. 200], respectively). A long-term (31 days-1 year) multivariable Cox regression analysis revealed that age, female sex, diabetes mellitus, prior coronary artery disease, Killip-Kimball class, and left ventricular ejection fraction were statistically significantly associated with . However, peak high-sensitivity troponin T and peak sensitive-contemporary troponin I were not significantly associated with (hazard ratio, 1. 03 [95% confidence interval, 0. 88-1. 20] [ P =0. 715]; and hazard ratio, 0. 99 [95% confidence interval, 0. 85-1. 15] [ P =0. 856], respectively). In the modern era, new-generation troponins do not provide significant prognostic information for predicting clinical events in . We should reconsider the value of serial troponin measurements for risk stratification in STEMI.
Grants:	Ministerio de Economía y Competitividad SAF2014-59892 Ministerio de Economía y Competitividad CB16/11/00403 Ministerio de Economía y Competitividad 16/11/00420
Note:	Altres ajuts: Fundació La Marató de TV3 (201502 and 201516)
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Myocardial infarction ; Prognosis ; ST-segment-elevation myocardial infarction ; Troponin
Published in:	Journal of the American Heart Association. Cardiovascular and cerebrovascular disease, Vol. 6, Num. 12 (december 2017) , ISSN 2047-9980

DOI: 10.1161/JAHA.117.007252
PMID: 29275366

10 p, 672.1 KB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
Articles > Published articles