title: Darapladib effect on circulating high sensitive troponin in patients with acute coronary syndromes.
abstract: OBJECTIVE
  We compared the incidence of late increase in hs-cTnI between ACS and non-ACS patients treated with standard of care with or without darapladib.
  
  
  METHODS
  A total of 323 (161 ACS and 162 non-ACS patients) were included. High sensitivity troponin I was measured at baseline and at 4, 13, 26 and 52 weeks.
  
  
  RESULTS
  ACS patients had statistically higher hs-cTnI values during longer term follow-up at which these patients were no longer in the acute setting of myocardial ischemia, but were regarded to have stable CAD (mean hsTnI value in ACS patients: 1.180 versus 0.886 ng/L in non-ACS patients, p = 0.02). Multivariate logistic regression revealed three predictors of any 2-fold increase in hs-cTnI levels compared to the previous visit when interactions were not considered. Treatment with darapladib (adjusted OR 0.53; 95% CI: 0.30-0.92) and initial presentation with ACS (adjusted OR 0.42; 95% CI: 0.23-0.77) were associated with less frequent occurrence of a 2-fold increase in hs-cTnI levels. In contrast, diabetes was associated with a higher incidence of 2-fold increases in hs-cTnI levels (adjusted OR 2.20; 95% CI: 1.04-4.64). Logistic regression to predict any 2-fold increase in hs-cTnI by ACS status showed that in the ACS group, treatment with darapladib decreased the risk of elevation of hs-cTnI (OR 0.219; 95% CI: 0.087, 0.553, p = 0.0013).
  
  
  CONCLUSIONS
  In patients with ACS, treatment with darapladib is associated with less increase in cardiac troponin I compared to standard of care alone. This beneficial effect may be associated with darapladib's capability of reducing necrotic core in coronary plaques.
authors.affiliation: Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands; Cardialysis, Rotterdam, The Netherlands. hect2701@gmail.com
authors.forename: Héctor M
authors.initials: HM
authors.lastname: García-García
authors.forename: Rohit M
authors.initials: RM
authors.lastname: Oemrawsingh
authors.forename: Salvatore
authors.initials: S
authors.lastname: Brugaletta
authors.forename: Pascal
authors.initials: P
authors.lastname: Vranckx
authors.forename: Jennifer
authors.initials: J
authors.lastname: Shannon
authors.forename: Richard
authors.initials: R
authors.lastname: Davies
authors.forename: Eric
authors.initials: E
authors.lastname: Boersma
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000188:drug therapy*; D000328:Adult; D000368:Aged; D001547:Benzaldehydes / Q000627:therapeutic use*; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010091:Oximes / Q000627:therapeutic use*; D019210:Troponin I / Q000097:blood*; D001713:Biphenyl Compounds; D004048:Diethylamines; D011744:Pyrimidinones; D013440:Sulfides
chemical_list: D001547:Benzaldehydes; D004791:Enzyme Inhibitors; D010091:Oximes; D019210:Troponin I; C529040:darapladib; D001713:Biphenyl Compounds; D004048:Diethylamines; D011744:Pyrimidinones; D013440:Sulfides