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.
N1 - Funding Information:
HAK has developed the cTnT assay and holds a patent jointly with Roche Diagnostics. He has received grants and research support from several companies, and has received honoraria for lectures from Roche Diagnostics, MSD, Roche, Lilly, Novartis, BMS, Astra, and Sanofi-Aventis. ASJ is a consultant too and receives research support from Dade-Behring, Beckman–Coulter and Ortho Diagnostics. He is or has been at one time a consultant to most of the major diagnostic companies, including Roche in the past. Dr. Neizel is a research fellow funded by an internal research program of the medical faculty of the University Hospital Aachen.
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 - CMR
KW - Cardiac troponin
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
SN - 1861-0684
VL - 98
SP - 555
EP - 562
JO - Clinical Research in Cardiology
JF - Clinical Research in Cardiology
IS - 9
ER -