| Combination of quantitative ST deviation and troponin elevation provides independent prognostic and therapeutic information in unstable angina and non-ST-elevation myocardial infarction. | |
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MedLine Citation:
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PMID: 16368287 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: ST deviation and troponin are indicators of risk in unstable angina/non-ST-elevation myocardial infarction with related but distinct pathophysiology. We hypothesized that a combination of the two would offer complementary information regarding the benefit of an invasive strategy. METHODS AND RESULTS: Electrocardiogram and troponin data were gathered in 1846 patients in TACTICS-TIMI 18. Adjusting for baseline characteristics, the independent odds ratio (OR) (95% CI) for death or myocardial infarction by 6 months was 1.29 (0.78-2.13) for 0.05 to 0.09 mV ST deviation, 1.83 (1.22-2.75) for > or = 0.10 mV ST deviation, 1.69 (0.96-2.97) for troponin T 0.01 to 0.10 ng/mL, and 2.32 (1.52-3.53) for troponin T > 0.10 ng/mL. There was a significant interaction between the magnitude of ST deviation and treatment strategy (P(interaction) = .04). After adjusting for troponin and other baseline characteristics, an early invasive strategy was associated with a 27% greater reduction in the odds of death or myocardial infarction in those with 0.05 to 0.09 mV of ST deviation (OR(interaction) 0.73, 95% CI 0.27-2.02) and a 64% greater reduction in those with > or = 0.10 mV (OR(interaction) 0.36, 95% CI 0.16-0.84) compared with in those without ST deviation. CONCLUSIONS: The magnitude of ST deviation and degree of troponin elevation are graded independent predictors of outcome in unstable angina/non-ST-elevation myocardial infarction. ST deviation complements troponin elevation in selecting patients for early invasive management. |
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Authors:
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Marc S Sabatine; David A Morrow; Carolyn H McCabe; Elliott M Antman; C Michael Gibson; Christopher P Cannon |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: American heart journal Volume: 151 ISSN: 1097-6744 ISO Abbreviation: Am. Heart J. Publication Date: 2006 Jan |
Date Detail:
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Created Date: 2005-12-21 Completed Date: 2006-03-31 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: United States |
Other Details:
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Languages: eng Pagination: 25-31 Citation Subset: AIM; IM |
Affiliation:
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TIMI Study Group, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA 02115, USA. msabatine@partners.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Angina, Unstable
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blood*,
mortality,
physiopathology*,
therapy Electrocardiography* Humans Myocardial Infarction / blood*, mortality, physiopathology*, therapy Prognosis Treatment Failure Troponin / blood* |
| Grant Support | |
ID/Acronym/Agency:
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R01 HL072872/HL/NHLBI NIH HHS; R01 HL072879/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Troponin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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