The Prognostic Value of Cardiac Troponin in a Revascularized Cohort with First-Time Myocardial Infarction.

IF 1.7 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiology Pub Date : 2025-08-28 DOI:10.1159/000548210

Nikki J Earle, Katrina K Poppe, Anna P Pilbrow, Greer Logue, Anna Rolleston, Helen Wihongi, Kimiora Henare, Thomas Lumley, Graeme Porter, Andrew J Kerr, Gerry Devlin, Ralph Stewart, Vicky A Cameron, Malcolm E Legget, Robert N Doughty

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引用次数: 0

Abstract

Introduction: The prognostic value of cardiac troponins in revascularized patients with myocardial infarction (MI) is uncertain. This study examined the relationship between peak troponin levels and adverse outcomes in a revascularized cohort from the Multi-Ethnic New Zealand Study of Acute Coronary Syndromes (MENZACS).

Methods: MENZACS enrolled patients with a first-time acute coronary syndrome from 2015 to 2019. Peak high sensitivity troponin was standardized by dividing the observed peak troponin by the upper limit of normal. The primary outcome was a composite of all-cause death or cardiovascular readmission, determined through national datasets. Troponin's relationship with outcomes was analysed using penalized spline Cox regression.

Results: Among 1,645 revascularized patients (81% male, mean age 61, 74% European, 14% Māori, 5% Pacific, 5% Indian, 3% Other; 46% ST-elevation MI (STEMI), 54% non-STEMI), higher peak troponin was associated with male sex, STEMI, current smoking, and elevated N-terminal pro-B-type natriuretic peptide levels. Over a median of 4.9 years, 402 (24%) people experienced the primary outcome. Peak troponin levels were not significantly associated with this outcome.

Conclusion: In this revascularized cohort surviving a first-time MI, the magnitude of peak troponin elevation was not associated with all-cause death or cardiovascular readmission.

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心肌肌钙蛋白在首次心肌梗死血运重建队列中的预后价值。

背景：心肌肌钙蛋白在心肌梗死（MI）血运重建术患者中的预后价值尚不确定。本研究在新西兰多民族急性冠状动脉综合征研究（MENZACS）的一个血运重建队列中检测了肌钙蛋白峰值水平与不良结局之间的关系。方法：MENZACS纳入2015-2019年首次急性冠状动脉综合征患者。用观察到的肌钙蛋白峰值除以正常值上限来标准化高灵敏度肌钙蛋白峰值。主要结局是通过国家数据集确定的全因死亡或心血管再入院的综合结果。采用惩罚样条Cox回归分析肌钙蛋白与预后的关系。结果：在1645例血运重建患者中（81%男性，平均年龄61岁，74%欧洲人，14% Māori， 5%太平洋人，5%印度人，3%其他；46% st段抬高心肌梗死，54%非st段抬高心肌梗死），较高的肌钙蛋白峰值与男性、st段抬高心肌梗死、当前吸烟和n端前b型利钠肽水平升高有关。在平均4.9年的时间里，402人（24%）经历了主要结局。肌钙蛋白峰值水平与该结果无显著相关性。结论：在这个首次心肌梗死存活的血运重建队列中，肌钙蛋白峰值升高的幅度与全因死亡或心血管再入院无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiology 医学-心血管系统

CiteScore

3.40

自引率

5.30%

发文量

审稿时长

1.5 months

期刊介绍： ''Cardiology'' features first reports on original clinical, preclinical and fundamental research as well as ''Novel Insights from Clinical Experience'' and topical comprehensive reviews in selected areas of cardiovascular disease. ''Editorial Comments'' provide a critical but positive evaluation of a recent article. Papers not only describe but offer critical appraisals of new developments in non-invasive and invasive diagnostic methods and in pharmacologic, nutritional and mechanical/surgical therapies. Readers are thus kept informed of current strategies in the prevention, recognition and treatment of heart disease. Special sections in a variety of subspecialty areas reinforce the journal''s value as a complete record of recent progress for all cardiologists, internists, cardiac surgeons, clinical physiologists, pharmacologists and professionals in other areas of medicine interested in current activity in cardiovascular diseases.