title: Predicting microvascular obstruction with cardiac troponin T after acute myocardial infarction: a correlative study with contrast-enhanced magnetic resonance imaging.
abstract: BACKGROUND
  The presence of microvascular obstruction (MVO) is associated with more severely impaired left ventricular function and adverse prognosis. The aim of this study was to evaluate whether a single cardiac troponin T-value (cTnT) was able to predict the presence of MVO and whether cTnT is an independent predictor of MVO as compared to usual risk factors.
  
  
  METHODS
  Sixty-one consecutive patients with reperfused ST-elevation myocardial infarction (STEMI) were enrolled in the study. cTnT was measured serially at admission and after 24, 48, 72 and 96 h. Contrast-enhanced cardiac magnetic resonance imaging (CE-MRI) was performed on a 1.5T MR-scanner 4 +/- 1 days after STEMI.
  
  
  RESULTS
  cTnT-time concentration kinetics in the presence of MVO differs from cTnT release in the absence of MVO showing a higher peak and a slower release. At single point measurement 24 h-cTnT correlates at least as well with the presence of MVO (P < 0.001) as peak cTnT (P = 0.0016) and sampling over 96 h (P < 0.001). Using ROC analysis, at single measurement a cTnT concentration >2.52 microg/l at 24 h was a predictor for MVO (AUC 0.91) with a sensitivity of 100% and a specificity of 80% with a positive predictive value of 76% and a negative predictive value of 100%. In multivariate regression analysis 24 h-cTnT remained independent predictor for MVO.
  
  
  CONCLUSIONS
  In STEMI, a single 24 h-cTnT value is an independent predictor for MVO and a convenient and inexpensive way to help define this important risk parameter in clinically routine.
authors: Medical Clinic III, University Hospital Heidelberg, Heidelberg, 69120, Germany. m.neizel@gmx.de
authors: Mirja
authors: M
authors: Neizel
authors: Simon
authors: S
authors: Futterer
authors: Henning
authors: H
authors: Steen
authors: Evangelos
authors: E
authors: Giannitsis
authors: Lars
authors: L
authors: Reinhardt
authors: Dirk
authors: D
authors: Lossnitzer
authors: Stephanie
authors: S
authors: Lehrke
authors: Allan S
authors: AS
authors: Jaffe
authors: Hugo A
authors: HA
authors: Katus
mesh_terms: D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D003287:Contrast Media; D023921:Coronary Stenosis / Q000097:blood* / Q000175:diagnosis*; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008833:Microcirculation; D055806:Microvessels / Q000378:metabolism / Q000473:pathology; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D003287:Contrast Media; D020107:Troponin T