Association of serial high sensitivity troponin T with onset of atrial fibrillation in ST elevation myocardial infarction patients undergoing primary percutaneous coronary intervention. Issue 1 (February 2016)

• Record Type: Journal Article
• Authors: Gal, Pim; Parlak, Emel; Schellings, Dirk AAM; Beukema, Rypko; ten Berg, Jurriën; Adiyaman, Ahmet; van 't Hof, Arnoud WJ; Elvan, Arif
• Is Part Of: European heart journal. Volume 5:Issue 1(2016)
• Page Start: 33
• Page End: 42
• Publication Date: 2016-02
• Subjects: Atrial fibrillation -- myocardial infarction -- biomarkers -- troponin; 616.1205
• DOI: 10.1177/2048872615570220
• Languages: English
• ISSNs: 2048-8726

Abstract

Aims: 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. Methods and results: 830 patients enrolled in On-TIME II were included. HsTnT was assessed at baseline, and 24h and 72h after admission for STEMI. New-onset AF episodes were divided into three subgroups: AF during the first 24h of admission, AF 24–72h after admission and AF >72h 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 24–72h after admission and 18 patients developed AF >72h 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 72h (AUC: 0.884, p <0.001) were associated with AF 24–72h and >72h after admission. HsTnT after 24h and 72h 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 72h (odds ratio: 1.035, p <0.001) showed the strongest association with post-infarction AF. Conclusion: Serial HsTnT plasma levels are associated with post-infarction, new-onset AF.