| Risk stratification in patients with inferior acute myocardial infarction treated by percutaneous coronary interventions: the role of admission troponin T. | |
| | |
MedLine Citation:
|
PMID: 11044417 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Cardiac troponin T (cTnT) elevations on admission indicate a high-risk subgroup of patients with ST-segment elevation acute myocardial infarction (AMI). This finding has been attributed to less effective reperfusion after thrombolytic therapy. The aim of this study was to determine the role of admission cTnT on the efficacy of percutaneous coronary interventions (PCIs) in inferior AMI. METHODS AND RESULTS: One hundred fifty-nine consecutive patients with inferior ST-segment AMI were enrolled and followed up for a mean of 448 days. Patients were stratified by cTnT on admission. A cTnT >/=0.1 microg/L was found in 58% of patients. These patients had longer time intervals from onset of symptoms to therapy (P:<0. 001) and higher 30-day (10.8% versus 1.5%, P:=0.027) and long-term (17.2% versus 4.5%, P:=0.023) cardiac mortalities. Rates of the combined end point of death, nonfatal reinfarction, and need for repeated target vessel revascularization procedures were not different in cTnT groups (log rank, 0.69; P:=0.41). PCI was attempted in 93.3% of cTnT-positive and 98.5% cTnT-negative patients (P:=0.24) but was less frequently successful in patients with cTnT >/=0.1 microg/L (77.9% versus 96.9%, P:<0.001). Coronary stenting reduced 30-day and long-term cardiac mortality, particularly among cTnT-positive patients. In a multivariate analysis, cTnT indicated an approximately 5-fold-higher risk (adjusted OR, 4.6; 95% CI, 0.79 to 27.11; P:=0.089) and was a strong albeit not independent risk predictor. CONCLUSIONS: In inferior AMI, a positive admission cTnT is associated with lower success rates of direct PCI and higher rates of cardiac events over the short and long term. These patients benefit from coronary stenting. |
| | |
Authors:
|
E Giannitsis; S Lehrke; U K Wiegand; V Kurowski; M Müller-Bardorff; B Weidtmann; G Richardt; H A Katus |
Related Documents
:
|
9257877 - Increased tissue factor pathway inhibitor in patients with acute myocardial infarction. 18571257 - The occurrence of acute myocardial infarction in relation to weather conditions. 18787977 - Correlation of antecedent stress myocardial perfusion imaging with the infarct related ... 10608047 - Survival in acute myocardial infarction induced by coronary ligation: prognostic releva... 17572247 - Comparable clinical outcomes with paclitaxel- and sirolimus-eluting stents in unrestric... 6854947 - Beneficial effects of the coronary collateral circulation on tachycardia-induced myocar... |
Publication Detail:
|
Type: Clinical Trial; Journal Article |
Journal Detail:
|
Title: Circulation Volume: 102 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2000 Oct |
Date Detail:
|
Created Date: 2000-10-30 Completed Date: 2000-11-13 Revised Date: 2004-11-17 |
Medline Journal Info:
|
Nlm Unique ID: 0147763 Medline TA: Circulation Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 2038-44 Citation Subset: IM |
Affiliation:
|
Medizinische Klinik II, Medizinische Universität zu Lübeck, Lübeck, Germany. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Acute Disease Aged Coronary Angiography Electrocardiography Female Humans Male Myocardial Infarction / diagnosis, metabolism*, radiography, therapy Outcome Assessment (Health Care) Risk Assessment Stents Troponin T / metabolism* |
| Chemical | |
Reg. No./Substance:
|
0/Troponin T |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: TIMI risk score for ST-elevation myocardial infarction: A convenient, bedside, clinical score for ri...
Next Document: A new role for P-selectin in shear-induced platelet aggregation.