Cardiac troponin I for prediction of clinical outcomes and cardiac function through 3-month follow-up after primary percutaneous coronary intervention for ST-segment elevation myocardial infarction

• Published in: The American heart journal 2015-02, Vol.169 (2), p.257-265.e1
• Main Authors: Hall, Trygve Sørdahl, MD, Hallén, Jonas, MD, PhD, Krucoff, Mitchell W., MD, Roe, Matthew T., MD, MHS, Brennan, Danielle M., MS, Agewall, Stefan, MD, PhD, Atar, Dan, MD, PhD, Lincoff, A. Michael, MD
• Format: Article
• Language: English
• Subjects: Area Under Curve; Cardiology; Cardiovascular; Clinical outcomes; Coronary Angiography; Electrocardiography; Female; Heart attacks; Humans; Laboratories; Male; Medicin och hälsovetenskap; Middle Aged; Myocardial Infarction - diagnosis; Myocardial Infarction - therapy; Natriuretic Peptide, Brain - blood; Outcome Assessment (Health Care) - methods; Peptide Fragments - blood; Percutaneous Coronary Intervention - adverse effects; Percutaneous Coronary Intervention - methods; Postoperative Complications - blood; Postoperative Complications - diagnosis; Postoperative Complications - physiopathology; Predictive Value of Tests; Prognosis; Risk Assessment - methods; Stroke Volume; Troponin I - blood; Ventricular Dysfunction, Left - blood; Ventricular Dysfunction, Left - diagnosis; Ventricular Dysfunction, Left - etiology; Ventricular Dysfunction, Left - physiopathology
• ISSN: 0002-8703; 1097-6744; 1097-6744
• DOI: 10.1016/j.ahj.2014.10.015

Background Circulating levels of cardiac troponin I (cTnI) after ST-segment elevation myocardial infarction (STEMI) are associated with infarct size and chronic left ventricular dysfunction, but the relation to clinical end points and biochemical measures of global cardiac function remains less well defined. Methods One thousand sixty-six patients receiving primary percutaneous coronary intervention (PCI) in the PROTECTION AMI trial were studied in a post hoc analysis. Cardiac troponin I was measured at several time points during the index hospitalization, and patients were followed up for 3 months before reassessment including N-terminal pro-B-type natriuretic peptide (NT-proBNP) and left ventricular ejection fraction (LVEF) measurements. Results The median (quartile 1-3) cTnI levels were 0.4 (0.1-0.4) μg/L at admission, 33.1 (12.8-72.1) μg/L after 16 to 24 hours, and 9.1 (3.9-17.5) μg/L after 70 to 80 hours. In adjusted models, all post-PCI single points, peak, and area under curve were found to be independently associated with clinical events, NT-proBNP >118 pmol/L, or LVEF