title: Association of serial high sensitivity troponin T with onset of atrial fibrillation in ST elevation myocardial infarction patients undergoing primary percutaneous coronary intervention.
abstract: OBJECTIVE
  Previous reports claimed that high sensitivity troponin T (HsTnT) is not associated with atrial fibrillation (AF) in the setting of acute ST-elevation myocardial infarction (STEMI) and primary percutaneous coronary intervention. However, the association of serial HsTnT levels and new-onset AF is unknown. We therefore assessed the temporal association between HsTnT levels and post-infarction AF.
  
  
  RESULTS
  830 patients enrolled in On-TIME II were included. HsTnT was assessed at baseline, and 24h and 72 h after admission for STEMI. New-onset AF episodes were divided into three subgroups: AF during the first 24h of admission, AF 24-72 h after admission and AF >72 h after admission. ROC analysis and binary logistic regression were performed. Mean age was 62 ± 12 years and 76% were male. Seventy-three patients developed new-onset AF: 41 patients developed AF during the first 24h of admission, 14 patients developed AF 24-72 h after admission and 18 patients developed AF >72 h after admission. HsTnT at baseline was associated with new-onset AF (area under curve (AUC) 0.596, p=0.008), but not with AF during the first 24h of admission (AUC: 0.539, p=0.414). HsTnT after 24h (AUC 0.792, p=0.001) and after 72 h (AUC: 0.884, p<0.001) were associated with AF 24-72 h and >72 h after admission. HsTnT after 24h and 72 h were stronger predictors of AF compared with HsTnT at baseline. In regression analysis, age (odds ratio 1.056, p<0.001), Killip Class >1 (odds ratio: 2.694, p=0.010) and HsTnT after 24h (odds ratio: 1.012, p=0.017) and after 72 h (odds ratio: 1.035, p<0.001) showed the strongest association with post-infarction AF.
  
  
  CONCLUSIONS
  Serial HsTnT plasma levels are associated with post-infarction, new-onset AF.
authors.affiliation: Cardiology Department of the Isala, Zwolle, The Netherlands.
authors.forename: Pim
authors.initials: P
authors.lastname: Gal
authors.affiliation: Cardiology Department of the Isala, Zwolle, The Netherlands.
authors.forename: Emel
authors.initials: E
authors.lastname: Parlak
authors.affiliation: Cardiology Department of the Slingeland Hospital, Doetinchem, The Netherlands.
authors.forename: Dirk A A M
authors.initials: DA
authors.lastname: Schellings
authors.affiliation: Cardiology Department of the Isala, Zwolle, The Netherlands.
authors.forename: Rypko
authors.initials: R
authors.lastname: Beukema
authors.affiliation: Cardiology Department of the St Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: Jurriën
authors.initials: J
authors.lastname: ten Berg
authors.affiliation: Cardiology Department of the Isala, Zwolle, The Netherlands.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Adiyaman
authors.affiliation: Cardiology Department of the Isala, Zwolle, The Netherlands.
authors.forename: Arnoud W J
authors.initials: AW
authors.lastname: van 't Hof
authors.affiliation: Cardiology Department of the Isala, Zwolle, The Netherlands v.r.c.derks@isala.nl.
authors.forename: Arif
authors.initials: A
authors.lastname: Elvan
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000188:drug therapy / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D012680:Sensitivity and Specificity; D000077466:Tirofiban; D020107:Troponin T / Q000097:blood*; D014443:Tyrosine / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D015415:Biomarkers; D005343:Fibrinolytic Agents; D020107:Troponin T; D014443:Tyrosine; D000077466:Tirofiban
keywords: Atrial fibrillation; biomarkers; myocardial infarction; troponin