Cardiac troponin T and creatine kinase predict mid-term infarct size and left ventricular function after acute myocardial infarction: A cardiac MR study

• Published in: Journal of magnetic resonance imaging 2011-04, Vol.33 (4), p.847-854
• Main Authors: Mayr, Agnes, Mair, Johannes, Klug, Gert, Schocke, Michael, Pedarnig, Kathrin, Trieb, Thomas, Pachinger, Otmar, Jaschke, Werner, Metzler, Bernhard
• Format: Article
• Language: English
• Subjects: acute myocardial infarction; Adult; Aged; cardiac magnetic resonance imaging; cardiac Troponin T; Contrast Media - pharmacology; creatine kinase; Creatine Kinase - metabolism; Female; functional recovery; Humans; Magnetic Resonance Imaging - methods; Male; Middle Aged; Myocardial Infarction - metabolism; Myocardium - metabolism; Predictive Value of Tests; ROC Curve; Time Factors; Troponin T - metabolism
• ISSN: 1053-1807; 1522-2586
• DOI: 10.1002/jmri.22491

Purpose: To assess the relation of cardiac troponin T (cTnT) and creatine kinase (CK) release with infarct size and left ventricular function evaluated during the subacute phase as well as four months after acute myocardial infarction (AMI) by contrast‐enhanced MRI (CE‐MRI). Materials and Methods: CMR of 80 patients (68 male, mean age 54.2 ± 11.7 years) was performed within 8 days and 4 months after first acute ST‐elevation AMI with successful primary angioplasty. CK and cTnT concentrations were determined serially from admission to day 4 after symptom onset. Results: All single time‐points, estimated average release and peak concentrations of CK and cTnT markers correlated significantly with acute and mid‐term infarct size (r = 0.43 to 0.79, all P < 0.001), ejection fraction (EF%) (r = −0.42 to −0.58, all P < 0.002) as well as with end‐systolic volume (ESV) (r = 0.32 to 0.57, all P < 0.002) at all times of assessment. Patients with cTnT concentrations below the cutoff value of 3.26 μg/L measured 48 h after AMI‐related symptom onset had a significant improvement in global (EF: P < 0.0001) myocardial function during the study period, whereas in those with cTnT ≥ 3.26 μg/L, functional recovery did not occur (P = 0.09). Conclusion: All single, mean and maximum concentrations of cTnT and CK measured within the first 4 days after AMI permit an accurate prediction of infarct size and left ventricular function as determined in the acute phase as well as four months after AMI by CE‐MRI. J. Magn. Reson. Imaging 2011;33:847–854. © 2011 Wiley‐Liss, Inc.