title: Effect on outcome of an increase of serum cardiac troponin T in patients with healing or healed ST-elevation myocardial infarction.
abstract: Recently, an association between minimally elevated cardiac troponin levels and cardiovascular risk in the general population has been reported. However, the prevalence and clinical importance of elevated cardiac troponin T (cTnT) levels remain unclear in patients with histories of myocardial infarction (MI). In this study, 1,807 consecutive patients with ST-segment elevation MIs were prospectively studied (77.1% men; mean age 64.4 years). Venous blood samples were obtained in the chronic stage of MI (28 +/- 7 days after onset), and serum cTnT levels were determined. During the average follow-up of 1,042 days, 84 patients died and 83 had nonfatal reinfarctions. Patients with cTnT levels in the highest quartile (> or = 0.040 ng/ml [n = 353]) had a higher incidence of all-cause death (8.2% vs 5.2%, p = 0.049) and nonfatal reinfarction (8.3% vs 5.1%, p = 0.048) than patients with cTnT levels from the lower 3 quartiles (<0.040 ng/ml [n = 1,064]). Multivariate Cox regression analysis revealed that a minimally elevated cTnT level (> or =0.040 ng/ml) was a significant predictor of all-cause mortality (hazard ratio 1.79, 95% confidence interval 1.10 to 2.90, p <0.02) and nonfatal reinfarction (hazard ratio 1.50, 95% confidence interval 1.13 to 2.20, p <0.03). Subgroup analysis showed that an elevated cTnT level was also a predictor of all-cause mortality and nonfatal reinfarction in patients without heart failure. In conclusion, minimally elevated cTnT levels in the chronic stage of MI predicted long-term adverse clinical outcomes.
authors: Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
authors: Masahiko
authors: M
authors: Shimizu
authors: Hiroshi
authors: H
authors: Sato
authors: Yasuhiko
authors: Y
authors: Sakata
authors: Daisaku
authors: D
authors: Nakatani
authors: Hiroya
authors: H
authors: Mizuno
authors: Shinichiro
authors: S
authors: Suna
authors: Kenshi
authors: K
authors: Fujii
authors: Yasunori
authors: Y
authors: Ueda
authors: Shinsuke
authors: S
authors: Nanto
authors: Masatsugu
authors: M
authors: Hori
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood* / Q000401:mortality*; D011379:Prognosis; D011446:Prospective Studies; D016019:Survival Analysis; D020107:Troponin T / Q000097:blood*
chemical_list: D020107:Troponin T