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Admission Troponin T and measurement of ST-segment resolution at 60 min improve early risk stratification in ST-elevation myocardial infarction

Författare och institution:
E. Bjorklund (-); B. Lindahl (-); Per Johanson (Hjärt-kärlinstitutionen); T. Jernberg (-); Ann-Marie Svensson (Hjärt-kärlinstitutionen); P. Venge (-); L. Wallentin (-); Mikael Dellborg (Hjärt-kärlinstitutionen)
Publicerad i:
Eur Heart J, 25 ( 2 ) s. 113-20
0195-668X (Print)
Artikel, refereegranskad vetenskaplig
Sammanfattning (abstract):
AIMS: The prognostic value of admission troponin T (tnT) levels and the resolution of the ST-segment elevation in ST-elevation myocardial infarction (STEMI) is well established. However, the combination of these two early available markers for predicting risk has not been evaluated. METHODS AND RESULTS: We evaluated 516 patients with fibrinolytic treated STEMI from the ASSENT-2 and ASSENT-PLUS studies, which had both admission tnT and ST-monitoring available. We used a prospectively defined cut-off value of tnT of 0.1microg/l. For ST-segment resolution, a cut-off of 50% measured after 60min was used. Both a tnT >/=0.1microg/l (n=116) and ST-segment resolution <50% (n=301) were related to higher one-year mortality, 13% vs 4% (P<0.001) and 8.4% vs 2.8% (P=0.009), respectively. In a multivariate analysis ST-segment resolution was and tnT showed a strong trend to be independently related to mortality. The combination of both further improved risk stratification. The one-year mortality in the group with elevation of tnT and without ST-segment resolution compared to the group without tnT elevation and with ST-segment resolution was 18.2% vs 2.8% (P<0.001). CONCLUSIONS: Both tnT on admission and ST-segment resolution after 60min are strong predictors of one-year mortality. The combination of both gives additive early information about prognosis and further improves risk stratification.
Ämne (baseras på Högskoleverkets indelning av forskningsämnen):
Arrhythmia/*diagnosis/mortality, Electrocardiography, Female, Hospitalization, Humans, Male, Middle Aged, Myocardial Infarction/*blood/mortality/therapy, Prognosis, Prospective Studies, Regression Analysis, Risk Factors, Thrombolytic Therapy/methods, Troponin T/*blood
Postens nummer:
Posten skapad:
2007-10-23 13:38

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