| Multiple biomarkers at admission significantly improve the prediction of mortality in patients undergoing primary percutaneous coronary intervention for acute ST-segment elevation myocardial infarction. | |
| | |
MedLine Citation:
|
PMID: 21185497 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVES: We investigated whether multiple biomarkers improve prognostication in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention. BACKGROUND: Few data exist on the prognostic value of combined biomarkers. METHODS: We used data from 1,034 STEMI patients undergoing primary percutaneous coronary intervention in a high-volume percutaneous coronary intervention center in the Netherlands and investigated whether combining N-terminal pro-brain natriuretic peptide, glucose, C-reactive protein, estimated glomerular filtration rate, and cardiac troponin T improved the prediction of mortality. A risk score was developed based on the strongest predicting biomarkers in multivariate Cox regression. The additional prognostic value of the strongest predicting biomarkers to the established prognostic factors (age, body weight, diabetes, hypertension, systolic blood pressure, heart rate, anterior myocardial infarction, and time to treatment) was assessed in multivariable Cox regression. RESULTS: During follow-up (median, 901 days), 120 of the 1,034 patients died. In Cox regression, glucose, estimated glomerular filtration rate, and N-terminal pro-brain natriuretic peptide were the strongest predictors for mortality (p < 0.05, for all). A risk score incorporating these biomarkers identified a high-risk STEMI subgroup with a significantly higher mortality when compared with an intermediate- or low-risk subgroup (p < 0.001). Addition of the 3 biomarkers to established prognostic factors significantly improved prediction for mortality, as shown by the net reclassification improvement (0.481, p < 0.001) [corrected] and integrated discrimination improvement (0.0226, p = 0.03) [corrected]. CONCLUSIONS: Our data suggest that addition of a multimarker to a model including established risk factors improves the prediction of mortality in STEMI patients undergoing primary percutaneous coronary intervention. Furthermore, the use of a simple risk score based on these biomarkers identifies a high-risk subgroup. |
| | |
Authors:
|
Peter Damman; Marcel A M Beijk; Wichert J Kuijt; Niels J W Verouden; Nan van Geloven; José P S Henriques; Jan Baan; Marije M Vis; Martijn Meuwissen; Jan P van Straalen; Johan Fischer; Karel T Koch; Jan J Piek; Jan G P Tijssen; Robbert J de Winter |
Related Documents
:
|
21138937 - Intracoronary administration of bone marrow-derived mononuclear cells and arrhythmic ev... 21349477 - Prevalence of left ventricular systolic dysfunction in adults with repaired tetralogy o... 21508007 - Local activation times at the high posterior wall of the left atrium during left atrial... 21467717 - Severe bleeding after antithrombotic therapy in urosepsis masquerading as myocardial in... 2144217 - Atrial enlargement as a consequence of atrial fibrillation. a prospective echocardiogra... 15886977 - Functional ischemic mitral regurgitation in anterior ventricular remodeling: results of... |
Publication Detail:
|
Type: Comparative Study; Journal Article |
Journal Detail:
|
Title: Journal of the American College of Cardiology Volume: 57 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2011 Jan |
Date Detail:
|
Created Date: 2010-12-27 Completed Date: 2011-03-22 Revised Date: 2011-06-07 |
Medline Journal Info:
|
Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
|
Languages: eng Pagination: 29-36 Citation Subset: AIM; IM |
Copyright Information:
|
Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
Affiliation:
|
Department of Cardiology, Academic Medical Center–University of Amsterdam, Amsterdam, the Netherlands. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Angioplasty, Balloon, Coronary
/
methods* Biological Markers / blood* C-Reactive Protein / metabolism Electrocardiography* Female Follow-Up Studies Humans Male Middle Aged Myocardial Infarction / blood, mortality*, therapy Natriuretic Peptide, Brain / blood Netherlands / epidemiology Patient Admission* Peptide Fragments / blood Prognosis Proportional Hazards Models Protein Precursors Receptor, Epidermal Growth Factor / blood Retrospective Studies Risk Factors Survival Rate / trends Troponin T / blood |
| Chemical | |
Reg. No./Substance:
|
0/Biological Markers; 0/Peptide Fragments; 0/Protein Precursors; 0/Troponin T; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain; 9007-41-4/C-Reactive Protein; EC 2.7.10.1/Receptor, Epidermal Growth Factor |
| Comments/Corrections | |
Comment In:
|
J Am Coll Cardiol. 2011 Jan 4;57(1):37-9
[PMID:
21185498
]
|
Erratum In:
|
J Am Coll Cardiol. 2011 Apr 19;57(16):1717-9 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Cerebral embolism following transcatheter aortic valve implantation: comparison of transfemoral and ...
Next Document: Screening for copy number variation in genes associated with the long QT syndrome: clinical relevanc...