TY - JOUR
T1 - Prognostic value of cardiac troponin T after myocardial infarction
T2 - A contemporary community experience
AU - Gerber, Yariv
AU - Jaffe, Allan S.
AU - Weston, Susan A.
AU - Jiang, Ruoxiang
AU - Roger, Véronique L.
N1 - Funding Information:
Grant Support: This work was supported in part by National Institutes of Health grant R01-HL59205 and the Rochester Epidemiology Project (grant number R01-AG034676 ; Principal Investigator: Walter A. Rocca, MD, MPH). Dr Roger is an Established Investigator of the American Heart Association. The funding sources played no role in the design, conduct, or reporting of this study.
PY - 2012/3
Y1 - 2012/3
N2 - Objective: To evaluate the role of cardiac troponin T (cTnT) in predicting death, recurrent ischemic events, and heart failure among community-dwelling persons with first myocardial infarction (MI). Patients and Methods: Consecutive Olmsted County, Minnesota, residents with an incident MI between November 6, 2002, and December 31, 2007, were studied (N=1177; mean age, 68 years). Maximal cTnT value was measured at a median of 1 day after MI (median, 0.52 ng/mL; interquartile range, 0.16-1.75 ng/mL) and evaluated as a prognostic factor using measures of absolute risk. Results: During a mean follow-up of 16 months, 276 deaths (23%) occurred, 341 patients (29%) experienced a recurrent ischemic event, and 326 patients (28%) experienced heart failure. A dose-response relationship was demonstrated early after MI between cTnT and the adjusted cumulative incidence of all outcomes. The multivariateadjusted absolute risk differences (events per 100 patients) between the upper and lower cTnT tertiles at 30 days were 5.8 (95% confidence interval [CI], 1.4-10.2) for death, 5.2 (95% CI, 0.2-10.3) for recurrent ischemic event, and 6.9 (95% CI, 1.4-12.4) for heart failure. These differences were either maintained or increased at 2 years. Conclusion: In the community, cTnT level predicts death and nonfatal cardiac events independently of other prognostic factors. The increased risk associated with elevated cTnT level appears shortly after MI and persists for at least 2 years.
AB - Objective: To evaluate the role of cardiac troponin T (cTnT) in predicting death, recurrent ischemic events, and heart failure among community-dwelling persons with first myocardial infarction (MI). Patients and Methods: Consecutive Olmsted County, Minnesota, residents with an incident MI between November 6, 2002, and December 31, 2007, were studied (N=1177; mean age, 68 years). Maximal cTnT value was measured at a median of 1 day after MI (median, 0.52 ng/mL; interquartile range, 0.16-1.75 ng/mL) and evaluated as a prognostic factor using measures of absolute risk. Results: During a mean follow-up of 16 months, 276 deaths (23%) occurred, 341 patients (29%) experienced a recurrent ischemic event, and 326 patients (28%) experienced heart failure. A dose-response relationship was demonstrated early after MI between cTnT and the adjusted cumulative incidence of all outcomes. The multivariateadjusted absolute risk differences (events per 100 patients) between the upper and lower cTnT tertiles at 30 days were 5.8 (95% confidence interval [CI], 1.4-10.2) for death, 5.2 (95% CI, 0.2-10.3) for recurrent ischemic event, and 6.9 (95% CI, 1.4-12.4) for heart failure. These differences were either maintained or increased at 2 years. Conclusion: In the community, cTnT level predicts death and nonfatal cardiac events independently of other prognostic factors. The increased risk associated with elevated cTnT level appears shortly after MI and persists for at least 2 years.
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U2 - 10.1016/j.mayocp.2011.11.013
DO - 10.1016/j.mayocp.2011.11.013
M3 - Article
C2 - 22386180
AN - SCOPUS:84857967983
SN - 0025-6196
VL - 87
SP - 247
EP - 254
JO - Mayo Clinic proceedings
JF - Mayo Clinic proceedings
IS - 3
ER -