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 language | English (US) |
|---|---|
| Pages (from-to) | 555-562 |
| Number of pages | 8 |
| Journal | Clinical Research in Cardiology |
| Volume | 98 |
| Issue number | 9 |
| DOIs | |
| State | Published - 2009 |
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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 journal › Article
}
TY - JOUR
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
Y1 - 2009
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
UR - http://www.scopus.com/inward/record.url?scp=70349584835&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=70349584835&partnerID=8YFLogxK
U2 - 10.1007/s00392-009-0041-1
DO - 10.1007/s00392-009-0041-1
M3 - Article
C2 - 19582365
AN - SCOPUS:70349584835
VL - 98
SP - 555
EP - 562
JO - Clinical Research in Cardiology
JF - Clinical Research in Cardiology
SN - 1861-0684
IS - 9
ER -