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Nguyen TL, French JK, Hogan J, et al. Prognostic value of high sensitivity troponin T after ST-segment elevation myocardial infarction in the era of cardiac magnetic resonance imaging. Eur Heart J Qual Care Clin Outcomes. 2016;2(3):164-171doi: 10.1093/ehjqcco/qcv033.
Nguyen, T. L., French, J. K., Hogan, J., Hee, L., Moses, D., Mussap, C. J., Rajaratnam, R., Juergens, C. P., Dimitri, H. R., Richards, D. A. B., & Thomas, L. (2016). Prognostic value of high sensitivity troponin T after ST-segment elevation myocardial infarction in the era of cardiac magnetic resonance imaging. European heart journal. Quality of care & clinical outcomes, 2(3), 164-171. https://doi.org/10.1093/ehjqcco/qcv033
Nguyen, Tuan L, et al. "Prognostic value of high sensitivity troponin T after ST-segment elevation myocardial infarction in the era of cardiac magnetic resonance imaging." European heart journal. Quality of care & clinical outcomes vol. 2,3 (2016): 164-171. doi: https://doi.org/10.1093/ehjqcco/qcv033
Nguyen TL, French JK, Hogan J, Hee L, Moses D, Mussap CJ, Rajaratnam R, Juergens CP, Dimitri HR, Richards DAB, Thomas L. Prognostic value of high sensitivity troponin T after ST-segment elevation myocardial infarction in the era of cardiac magnetic resonance imaging. Eur Heart J Qual Care Clin Outcomes. 2016 Jul 01;2(3):164-171. doi: 10.1093/ehjqcco/qcv033. PMID: 29474609.
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Eur Heart J Qual Care Clin Outcomes. 2016 Jul 01;2(3):164-171. doi: 10.1093/ehjqcco/qcv033.

Prognostic value of high sensitivity troponin T after ST-segment elevation myocardial infarction in the era of cardiac magnetic resonance imaging.

European heart journal. Quality of care & clinical outcomes

Tuan L Nguyen, John K French, Jarred Hogan, Leia Hee, Daniel Moses, Christian J Mussap, Rohan Rajaratnam, Craig P Juergens, Hany R Dimitri, David A B Richards, Liza Thomas

Affiliations

  1. Cardiology Department, Liverpool Hospital, Elizabeth Street, Sydney, NSW 2170, Australia.
  2. South Western Sydney Clinical School, The University of NSW, Sydney, NSW, Australia.
  3. Radiology Department, Liverpool Hospital, Sydney, NSW, Australia.
  4. School of Medicine, University of Western Sydney, Campbelltown, NSW, Australia.

PMID: 29474609 DOI: 10.1093/ehjqcco/qcv033

Abstract

AIMS: To determine if high sensitivity troponin T (hs-TnT) measurements performed during the 'plateau phase' of troponin release (≥48 h) following ST-segment elevation myocardial infarction (STEMI) can predict major adverse cardiovascular endpoints (MACE), and to evaluate its prognostic value compared with cardiac magnetic resonance imaging (CMRI) parameters.

METHODS AND RESULTS: We prospectively recruited 201 first presentation STEMI patients. Serial hs-TnT levels were measured at admission, peak (highest), 24, 48 and 72 h. CMRI and transthoracic echocardiography were performed (4 days median) post-STEMI, evaluating infarct scar characteristics and left ventricular ejection fraction (LVEF). Associations were determined between hs-TnT levels and CMRI parameters early after STEMI with MACE (comprising mortality, re-infarction, new or worsening of heart failure, cerebrovascular accident, and sustained ventricular arrhythmias) at medium-term follow-up. After 602 days (median), 33 (17%) patients had MACE. Upper tertile hs-TnT levels at 48 and 72 h were associated with MACE (Kaplan-Meier P = 0.002 and P = 0.012, respectively). Multivariate Cox analyses, incorporating diabetes, CMRI scar size, LVEF and hs-TnT levels (applied at a single hs-TnT time point) showed that 48 and 72 h hs-TnT levels were independent predictors for MACE (HR = 1.20, P = 0.002, and HR = 1.21, P = 0.035 respectively).

CONCLUSION: Measurement of hs-TnT in the plateau phase after STEMI is an inexpensive method of prognostic risk assessment.

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