title: Usefulness of serum troponin T levels on day three or four in predicting survival after acute myocardial infarction.
abstract: The appearance of serum troponin T (tn-T) on day 1 after acute myocardial infarction (AMI) strongly depends on coronary reperfusion. In contrast, the kinetics of tn-T release after day 1 after AMI are unaffected by the reperfusion status, and reflect the degradation of myofilaments in irreversibly damaged cells. However, it is not known whether serum tn-T levels after day 1 after AMI can be used to predict the long-term outcome. The purpose of this study was to elucidate the prognostic value of determining the tn-T level on day 3 or 4 after AMI. Serum tn-T levels on day 3 or 4 after AMI were measured in 121 patients (92 men and 29 women, mean age 65 years). Mean follow-up period was 526 days. There were 12 deaths (9 cardiac and 3 noncardiac) during the follow-up period. By Kaplan-Meier analysis, patients with tn-T levels higher than the median level (6.9 ng/ml) had a significantly higher mortality rate than those with submedian levels (p <0.01). By multivariate Cox proportional-hazards regression analysis, the serum tn-T level was an independent predictor of the long-term outcome after AMI (p <0.01). Futhermore, in patients with a first AMI, the serum tn-T level exhibited a significant negative linear correlation with left ventricular ejection fraction assessed 4 weeks after AMI (r = -0.48, p <0.001). Increased serum tn-T levels on day 3 or 4 after AMI are a powerful noninvasive predictor of poor long-term prognosis, reflecting residual left ventricular function after AMI.
authors.affiliation: Division of Cardiology, National Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Kanna
authors.forename: H
authors.initials: H
authors.lastname: Nonogi
authors.forename: H
authors.initials: H
authors.lastname: Sumida
authors.forename: S
authors.initials: S
authors.lastname: Miyazaki
authors.forename: S
authors.initials: S
authors.lastname: Daikoku
authors.forename: I
authors.initials: I
authors.lastname: Morii
authors.forename: S
authors.initials: S
authors.lastname: Yasuda
authors.forename: Y
authors.initials: Y
authors.lastname: Sutani
authors.forename: T
authors.initials: T
authors.lastname: Baba
authors.forename: Y
authors.initials: Y
authors.lastname: Goto
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000401:mortality*; D011237:Predictive Value of Tests; D012372:ROC Curve; D013318:Stroke Volume / Q000502:physiology; D015996:Survival Rate; D020107:Troponin T / Q000097:blood*
chemical_list: D020107:Troponin T