Predicting microvascular obstruction with cardiac troponin T after acute myocardial infarction: A correlative study with contrast-enhanced magnetic resonance imaging

Mirja Neizel, Simon Futterer, Henning Steen, Evangelos Giannitsis, Lars Reinhardt, Dirk Lossnitzer, Stephanie Lehrke, Allan S Jaffe, Hugo A. Katus

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background: The presence of microvascular obstruction (MVO) is associated with more severely impaired left ventricular function and adverse prognosis. The aim of this study was to evaluate whether a single cardiac troponin T-value (cTnT) was able to predict the presence of MVO and whether cTnT is an independent predictor of MVO as compared to usual risk factors. Study design and methods: Sixty-one consecutive patients with reperfused ST-elevation myocardial infarction (STEMI) were enrolled in the study. cTnT was measured serially at admission and after 24, 48, 72 and 96 h. Contrast-enhanced cardiac magnetic resonance imaging (CE-MRI) was performed on a 1.5T MR-scanner 4 ± 1 days after STEMI. Results: cTnT-time concentration kinetics in the presence of MVO differs from cTnT release in the absence of MVO showing a higher peak and a slower release. At single point measurement 24 h-cTnT correlates at least as well with the presence of MVO (P < 0.001) as peak cTnT (P = 0.0016) and sampling over 96 h (P < 0.001). Using ROC analysis, at single measurement a cTnT concentration >2.52 μg/l at 24 h was a predictor for MVO (AUC 0.91) with a sensitivity of 100% and a specificity of 80% with a positive predictive value of 76% and a negative predictive value of 100%. In multivariate regression analysis 24 h-cTnT remained independent predictor for MVO. Conclusions: In STEMI, a single 24 h-cTnT value is an independent predictor for MVO and a convenient and inexpensive way to help define this important risk parameter in clinically routine.

Original languageEnglish (US)
Pages (from-to)555-562
Number of pages8
JournalClinical Research in Cardiology
Volume98
Issue number9
DOIs
StatePublished - 2009

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Troponin T
Myocardial Infarction
Magnetic Resonance Imaging
Left Ventricular Function
Area Under Curve
Multivariate Analysis
Regression Analysis

Keywords

  • Cardiac troponin
  • CMR
  • Microvascular obstruction
  • Myocardial infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Predicting microvascular obstruction with cardiac troponin T after acute myocardial infarction : A correlative study with contrast-enhanced magnetic resonance imaging. / Neizel, Mirja; Futterer, Simon; Steen, Henning; Giannitsis, Evangelos; Reinhardt, Lars; Lossnitzer, Dirk; Lehrke, Stephanie; Jaffe, Allan S; Katus, Hugo A.

In: Clinical Research in Cardiology, Vol. 98, No. 9, 2009, p. 555-562.

Research output: Contribution to journalArticle

Neizel, Mirja ; Futterer, Simon ; Steen, Henning ; Giannitsis, Evangelos ; Reinhardt, Lars ; Lossnitzer, Dirk ; Lehrke, Stephanie ; Jaffe, Allan S ; Katus, Hugo A. / Predicting microvascular obstruction with cardiac troponin T after acute myocardial infarction : A correlative study with contrast-enhanced magnetic resonance imaging. In: Clinical Research in Cardiology. 2009 ; Vol. 98, No. 9. pp. 555-562.
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abstract = "Background: The presence of microvascular obstruction (MVO) is associated with more severely impaired left ventricular function and adverse prognosis. The aim of this study was to evaluate whether a single cardiac troponin T-value (cTnT) was able to predict the presence of MVO and whether cTnT is an independent predictor of MVO as compared to usual risk factors. Study design and methods: Sixty-one consecutive patients with reperfused ST-elevation myocardial infarction (STEMI) were enrolled in the study. cTnT was measured serially at admission and after 24, 48, 72 and 96 h. Contrast-enhanced cardiac magnetic resonance imaging (CE-MRI) was performed on a 1.5T MR-scanner 4 ± 1 days after STEMI. Results: cTnT-time concentration kinetics in the presence of MVO differs from cTnT release in the absence of MVO showing a higher peak and a slower release. At single point measurement 24 h-cTnT correlates at least as well with the presence of MVO (P < 0.001) as peak cTnT (P = 0.0016) and sampling over 96 h (P < 0.001). Using ROC analysis, at single measurement a cTnT concentration >2.52 μg/l at 24 h was a predictor for MVO (AUC 0.91) with a sensitivity of 100{\%} and a specificity of 80{\%} with a positive predictive value of 76{\%} and a negative predictive value of 100{\%}. In multivariate regression analysis 24 h-cTnT remained independent predictor for MVO. Conclusions: In STEMI, a single 24 h-cTnT value is an independent predictor for MVO and a convenient and inexpensive way to help define this important risk parameter in clinically routine.",
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T1 - Predicting microvascular obstruction with cardiac troponin T after acute myocardial infarction

T2 - A correlative study with contrast-enhanced magnetic resonance imaging

AU - Neizel, Mirja

AU - Futterer, Simon

AU - Steen, Henning

AU - Giannitsis, Evangelos

AU - Reinhardt, Lars

AU - Lossnitzer, Dirk

AU - Lehrke, Stephanie

AU - Jaffe, Allan S

AU - Katus, Hugo A.

PY - 2009

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N2 - Background: The presence of microvascular obstruction (MVO) is associated with more severely impaired left ventricular function and adverse prognosis. The aim of this study was to evaluate whether a single cardiac troponin T-value (cTnT) was able to predict the presence of MVO and whether cTnT is an independent predictor of MVO as compared to usual risk factors. Study design and methods: Sixty-one consecutive patients with reperfused ST-elevation myocardial infarction (STEMI) were enrolled in the study. cTnT was measured serially at admission and after 24, 48, 72 and 96 h. Contrast-enhanced cardiac magnetic resonance imaging (CE-MRI) was performed on a 1.5T MR-scanner 4 ± 1 days after STEMI. Results: cTnT-time concentration kinetics in the presence of MVO differs from cTnT release in the absence of MVO showing a higher peak and a slower release. At single point measurement 24 h-cTnT correlates at least as well with the presence of MVO (P < 0.001) as peak cTnT (P = 0.0016) and sampling over 96 h (P < 0.001). Using ROC analysis, at single measurement a cTnT concentration >2.52 μg/l at 24 h was a predictor for MVO (AUC 0.91) with a sensitivity of 100% and a specificity of 80% with a positive predictive value of 76% and a negative predictive value of 100%. In multivariate regression analysis 24 h-cTnT remained independent predictor for MVO. Conclusions: In STEMI, a single 24 h-cTnT value is an independent predictor for MVO and a convenient and inexpensive way to help define this important risk parameter in clinically routine.

AB - Background: The presence of microvascular obstruction (MVO) is associated with more severely impaired left ventricular function and adverse prognosis. The aim of this study was to evaluate whether a single cardiac troponin T-value (cTnT) was able to predict the presence of MVO and whether cTnT is an independent predictor of MVO as compared to usual risk factors. Study design and methods: Sixty-one consecutive patients with reperfused ST-elevation myocardial infarction (STEMI) were enrolled in the study. cTnT was measured serially at admission and after 24, 48, 72 and 96 h. Contrast-enhanced cardiac magnetic resonance imaging (CE-MRI) was performed on a 1.5T MR-scanner 4 ± 1 days after STEMI. Results: cTnT-time concentration kinetics in the presence of MVO differs from cTnT release in the absence of MVO showing a higher peak and a slower release. At single point measurement 24 h-cTnT correlates at least as well with the presence of MVO (P < 0.001) as peak cTnT (P = 0.0016) and sampling over 96 h (P < 0.001). Using ROC analysis, at single measurement a cTnT concentration >2.52 μg/l at 24 h was a predictor for MVO (AUC 0.91) with a sensitivity of 100% and a specificity of 80% with a positive predictive value of 76% and a negative predictive value of 100%. In multivariate regression analysis 24 h-cTnT remained independent predictor for MVO. Conclusions: In STEMI, a single 24 h-cTnT value is an independent predictor for MVO and a convenient and inexpensive way to help define this important risk parameter in clinically routine.

KW - Cardiac troponin

KW - CMR

KW - Microvascular obstruction

KW - Myocardial infarction

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