Relation of troponin T release kinetics to long-term clinical outcome in patients with acute ST segment elevation myocardial infarction treated with a percutaneous intervention.
The purpose of this study was to determine the relation of troponin T release kinetics to long-term clinical outcome in patients with an acute ST segment elevation myocardial infarction treated with a primary percutaneous intervention. One hundred and four patients with typical ischemic chest pain and > 1.5 mm ST segment elevation in > 2 contiguous leads underwent primary stenting (n = 60) or primary percutaneous transluminal coronary angioplasty (n = 44). Serum troponin T concentrations were obtained prior to and serially postintervention for 72 hr. Mean time to peak serum troponin T concentration was significantly longer in patients with cardiac death (P = 0.02), reinfarction (P = 0.007), target lesion reintervention (P = 0.03), and the composite of these events (13.2 +/- 5.3 vs. 9.3 +/- 4.0 hr; P < 0.0005). Multivariate analysis identified age, Killip class > 2, and time to peak serum troponin T concentration as independent predictors of long-term cardiac event-free survival. Thus, time to peak serum troponin T concentration independently predicts long-term cardiac event-free survival in patients with acute ST segment elevation myocardial infarction treated with a primary percutaneous intervention.
Department of Cardiology, Athens General Hospital, Athens, Greece.
Apostolos J
AJ
Karavidas
Antony D
AD
Vrachatis
Martin A
MA
Alpert
Dimitris J
DJ
Nikas
Dionissios I
DI
Achtypis
Evagellas P
EP
Masrakas
Masolis G
MG
Foukarakis
Toannis N
TN
Fotiades
Apostolos A
AA
Zacharoulis
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000401:mortality / Q000628:therapy*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D016019:Survival Analysis; D016896:Treatment Outcome; D020107:Troponin T / Q000097:blood*
D020107:Troponin T