High-sensitivity troponin T for prediction of left ventricular function and infarct size one year following ST-elevation myocardial infarction. (1st January 2016)

• Record Type: Journal Article
• Authors: Reinstadler, Sebastian Johannes; Feistritzer, Hans-Josef; Klug, Gert; Mair, Johannes; Tu, Alexander Minh-Duc; Kofler, Markus; Henninger, Benjamin; Franz, Wolfgang-Michael; Metzler, Bernhard
• Is Part Of: International journal of cardiology. Volume 202(2016)
• Page Start: 188
• Page End: 193
• Publication Date: 2016-01-01
• Subjects: High-sensitivity cardiac troponin T -- Myocardial infarction -- Magnetic resonance imaging; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2015.09.001
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: Data relating high-sensitivity cardiac troponin T (hs-cTnT) to long-term myocardial function and infarct size in patients after ST-elevation myocardial infarction (STEMI) are lacking. We aimed to evaluate the use of early hs-cTnT concentrations for prediction of myocardial function and infarct size assessed by cardiac magnetic resonance imaging (CMR) one year following STEMI. Methods: Sixty-six patients, revascularized by primary percutaneous coronary intervention (PCI) for first-time STEMI, were enrolled in this observational study. Serial hs-cTnT, creatine kinase (CK), high-sensitivity C-reactive protein (hs-CRP) and lactate dehydrogenase (LDH) levels were measured on admission, 6 h, 12 h, and 24 h post-PCI. Patients underwent CMR within the first week and 12 months thereafter. Results: Except for admission hs-cTnT, all single time point and peak hs-cTnT concentrations showed significant correlations with left ventricular ejection fraction (LVEF: r = − 0.404 to − 0.517, all ps < 0.01) and infarct size (IS: r = 0.421 to 0.700, all ps < 0.01) at baseline and follow-up. The area under the curve (AUC) of peak hs-cTnT was 0.82 (95% CI 0.71–0.92) for the prediction of decreased LVEF (< 55%) and 0.89 (95% CI 0.81–0.97) for the prediction of large IS (> 8%) at 12 months. The combination of all four biomarkers resulted in an AUC of 0.82 and 0.92 for the prediction of reduced LVEF and large IS at 12 months, respectively (both ps > 0.05). Conclusion: In stable STEMI patients successfully revascularized by primary PCI, serial and peak concentrations of hs-cTnT are closely correlated to long-term LVEF and IS. Combination of hs-cTnT with CK, hs-CRP, or LDH did not add any significant prognostic value as compared with hs-cTnT alone.