Different Prognostic Significance of Cardiac Troponin at Presentation and Peak Cardiac Troponin in Patients with Non-ST Segment Elevation Myocardial Infarction.
Non-ST elevation myocardial infarction (NSTEMI) is one of the most common manifestations of acute coronary syndromes (ACS). We evaluated the prognostic role of cardiac troponin I (cTnI) at presentation and peak cardiac troponin I in patients with NSTEMI.



We consecutively enrolled 215 subjects presenting with NSTEMI. Subjects were followed up for 1 year. cTnI at presentation and the peak value of cTnI were measured. The primary end point was defined as cardiovascular death, readmission to hospital with heart failure and new ACS.



The subjects who presented the primary end point (49 subjects) had significantly increased values of peak cTnI compared to subjects free of cardiovascular events [7.19 (2.97-21.32) vs. 4.09 (1.18-11.85) ng/l; p = 0.002]. Nevertheless, cTnI at presentation did not differ between subjects who presented the primary end point and those free of events (p = 0.39). Multivariate Cox regression analysis after adjustment for confounders revealed by the univariate analysis showed that for an increase in peak cTnI from 1 to 10 ng/l, there is a 60% anticipated increase in the relative risk to present the primary end point (p = 0.04).



These findings documented the different prognostic significance of cTnI at presentation and peak cTnI in patients presenting with NSTEMI, and highlighted the importance of monitoring the levels of cTnI in this high-risk population.
1st Department of Cardiology, x2018;Hippokration' Hospital, Athens, Greece.
Gerasimos
G
Siasos
George
G
Lazaros
Evangelos
E
Oikonomou
Theodoros
T
Zografos
Dimitris
D
Athanasiou
Manolis
M
Vavuranakis
Alexis
A
Antonopoulos
Vasiliki
V
Tsigkou
Christodoulos
C
Stefanadis
Athanasios G
AG
Papavassiliou
Dimitris
D
Tousoulis
D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000453:epidemiology; D000368:Aged; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D003955:Diagnostic Tests, Routine / Q000379:methods*; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D000072658:Non-ST Elevated Myocardial Infarction / Q000097:blood / Q000175:diagnosis / Q000401:mortality; D017063:Outcome Assessment, Health Care / Q000379:methods; D010343:Patient Admission / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D011379:Prognosis; D012008:Recurrence; D019210:Troponin I / Q000032:analysis / Q000097:blood; D014481:United States / Q000453:epidemiology
D015415:Biomarkers; D019210:Troponin I