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The predictive potential of asymptomatic mild elevation of cardiac troponin I on mortality risk of stable patients with vascular disease
O. Mayer, J. Seidlerová, J. Bruthans, J. Vaněk, L. Černá, P. Wohlfahrt, J. Filipovský, R. Cífková, J. Windrichová, O. Topolčan,
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články, práce podpořená grantem
Grantová podpora
NT12102
MZ0
CEP - Centrální evidence projektů
NT13186
MZ0
CEP - Centrální evidence projektů
Digitální knihovna NLK
Plný text - Článek
Plný text - Článek
Zdroj
Zdroj
Odkazy
PubMed
25091937
DOI
10.1016/j.clinbiochem.2014.07.022
Knihovny.cz E-zdroje
- MeSH
- asymptomatické nemoci * mortalita MeSH
- biologické markery krev MeSH
- cévní mozková příhoda krev diagnóza mortalita MeSH
- ischemie mozku krev diagnóza mortalita MeSH
- kohortové studie MeSH
- koronární nemoc krev diagnóza mortalita MeSH
- lidé středního věku MeSH
- lidé MeSH
- mortalita trendy MeSH
- následné studie MeSH
- prediktivní hodnota testů MeSH
- prospektivní studie MeSH
- rizikové faktory MeSH
- senioři MeSH
- troponin I krev MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
OBJECTIVES: Due to improved analytical performance of the newest generation of troponin assays, several patients have mild elevations of this parameter. Nevertheless, they do not show any signs of acute coronary syndrome. We speculated whether non-acute cardiac troponin I (cTnI) concentrations may improve prediction of residual mortality risk in clinically stable outpatients with chronic vascular disease. DESIGN AND METHODS: We followed 830 patients (mean age 65.2years) after myocardial infarction, coronary revascularization or first ischemic stroke (pooled Czech samples of EUROASPIRE III and EUROASPIRE-stroke surveys, interviewed in 2006/2007) in a prospective cohort study. In addition to standard protocol, troponin I and brain natriuretic peptide (BNP) was estimated from frozen samples. Vital status and declared cause of death from death certificates was registered to ascertain a 5-year all-cause and cardiovascular mortality. RESULTS: During a median follow up of 2050days (5.6years) 168 patients died. In the multivariate Cox proportional hazard model, cTnI≥0.03ng/mL independently predicted an all-cause 5-year mortality with HRR 1.76 (95% CI: 1.09-2.83). In the Cox model, the better predictor of mortality was BNP >150ng/L [HRR 3.47 (95% CI: 2.23-5.41)]. However, the combination of BNP with cTnI did not substantially improve its sensitivity or predictive power. CONCLUSION: We cannot confirm the utility of asymptomatic mild cTnI elevation as a tool to detect residual risk of stable patients with vascular disease. On the other hand, BNP seems to be more appropriate for this purpose.
Biomedical Center Medical Faculty of Charles University Pilsen Czech Republic
Department of Immunodiagnostics University Hospital Pilsen Czech Republic
Department of Neurology University Hospital Pilsen Czech Republic
International Clinical Research Centre St Anne's University Hospital Brno Czech Republic
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- $a OBJECTIVES: Due to improved analytical performance of the newest generation of troponin assays, several patients have mild elevations of this parameter. Nevertheless, they do not show any signs of acute coronary syndrome. We speculated whether non-acute cardiac troponin I (cTnI) concentrations may improve prediction of residual mortality risk in clinically stable outpatients with chronic vascular disease. DESIGN AND METHODS: We followed 830 patients (mean age 65.2years) after myocardial infarction, coronary revascularization or first ischemic stroke (pooled Czech samples of EUROASPIRE III and EUROASPIRE-stroke surveys, interviewed in 2006/2007) in a prospective cohort study. In addition to standard protocol, troponin I and brain natriuretic peptide (BNP) was estimated from frozen samples. Vital status and declared cause of death from death certificates was registered to ascertain a 5-year all-cause and cardiovascular mortality. RESULTS: During a median follow up of 2050days (5.6years) 168 patients died. In the multivariate Cox proportional hazard model, cTnI≥0.03ng/mL independently predicted an all-cause 5-year mortality with HRR 1.76 (95% CI: 1.09-2.83). In the Cox model, the better predictor of mortality was BNP >150ng/L [HRR 3.47 (95% CI: 2.23-5.41)]. However, the combination of BNP with cTnI did not substantially improve its sensitivity or predictive power. CONCLUSION: We cannot confirm the utility of asymptomatic mild cTnI elevation as a tool to detect residual risk of stable patients with vascular disease. On the other hand, BNP seems to be more appropriate for this purpose.
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