title: Predictors of elevated cardiac troponin T on admission in ST-segment elevation myocardial infarction.
abstract: BACKGROUND
  In patients with ST-segment elevation acute myocardial infarction (STEMI), elevated cardiac troponin T (cTnT) on admission is associated with poorer outcomes despite early reperfusion. Presentation delay is thought to be the most important factor for the elevation of cTnT on admission. We evaluated presentation delay and other potential predictors of elevated cTnT on admission in patients treated with primary percutaneous coronary interventions (PCI) for STEMI.
  
  
  METHODS
  CTnT was measured upon arrival in the PCI centre in 444 patients with acute STEMI. An elevated cTnT was defined as > 0.05 microg/L.
  
  
  RESULTS
  The mean age was 61.7 years and patients were admitted at a median of 155 min after symptom onset. Almost 50% had an elevated cTnT on admission. Patients with a positive cTnT on admission were less likely to have successful primary PCI (87 versus 93%, P=0.048) and had significantly higher rates of one-year mortality (4.9 versus 1.3%, P=0.031). There was a significant association between presentation delay and the prevalence of elevated admission cTnT, but even patients with early presentation (<120 min after symptom onset) still had a high prevalence of elevated cTnT (33%). After multivariate analysis, apart from presentation delay, anterior MI location and higher age were independent predictors of elevated cTnT on admission.
  
  
  CONCLUSIONS
  In patients with STEMI, the prevalence of elevated cTnT on admission is high, even in patients with early presentation. Independent predictors of elevated cTnT on admission are presentation delay, increasing age and anterior MI location.
authors.affiliation: Isala Klinieken, Locatie Weezenlanden, Department of Cardiology, Groot Wezenland 20, 8011 JW Zwolle, The Netherlands.
authors.forename: Saman
authors.initials: S
authors.lastname: Rasoul
authors.forename: Mark B
authors.initials: MB
authors.lastname: Nienhuis
authors.forename: Jan Paul
authors.initials: JP
authors.lastname: Ottervanger
authors.forename: Robbert J
authors.initials: RJ
authors.lastname: Slingerland
authors.forename: Menko-Jan
authors.initials: MJ
authors.lastname: de Boer
authors.forename: Jan-Henk E
authors.initials: JH
authors.lastname: Dambrink
authors.forename: Nicolette M
authors.initials: NM
authors.lastname: Ernst
authors.forename: Jan C A
authors.initials: JC
authors.lastname: Hoorntje
authors.forename: A T Marcel
authors.initials: AT
authors.lastname: Gosselink
authors.forename: Harry
authors.initials: H
authors.lastname: Suryapranata
authors.forename: Felix
authors.initials: F
authors.lastname: Zijlstra
authors.forename: Arnoud W J
authors.initials: AW
authors.lastname: van 't Hof
mesh_terms: D000368:Aged; D002624:Chemistry, Clinical / Q000379:methods*; D017023:Coronary Angiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis*; D015425:Myocardial Reperfusion; D009206:Myocardium / Q000378:metabolism*; D011379:Prognosis; D016896:Treatment Outcome; D020107:Troponin T / Q000097:blood*
chemical_list: D020107:Troponin T