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  • Open Access

Predictive value of high-sensitive troponin t versus conventional biomarkers for 1-year left ventricular function and infarct size after STEMI

  • 1,
  • 1,
  • 1,
  • 1,
  • 2,
  • 1 and
  • 1
Journal of Cardiovascular Magnetic Resonance201517 (Suppl 1) :P178

https://doi.org/10.1186/1532-429X-17-S1-P178

  • Published:

Keywords

  • Percutaneous Coronary Intervention
  • Leave Ventricular Ejection Fraction
  • Creatine Kinase
  • Infarct Size
  • Cardiac Magnetic Resonance

Background

Data relating high-sensitive troponin T (hs-cTnT) to long-term myocardial function and damage in patients after STEMI are lacking. We evaluated the use of serial and peak concentrations of hs-cTnT versus creatine kinase (CK), lactate dehydrogenase (LDH) and high sensitive C-reactive protein (hs-CRP) for prediction of myocardial function as well as infarct scar assessed by cardiac magnetic resonance imaging (CMR) one year after first ST-segment elevation myocardial infarction (STEMI).

Methods

Sixty-six patients receiving primary percutaneous coronary intervention (p-PCI) for first STEMI were enrolled in this single-centre, observational study. All participants underwent cine and contrast-enhanced CMR within the first week and 12 months after the index event. Serial biomarkers were determined on admission, 6 h, 12 h, 24 h, and 12 months following p-PCI. Hs-cTnT concentrations were measured by a fourth generation high-sensitive immunoassay (Roche Diagnostics®). Other biomarkers were assessed using commercially available assays.

Results

Except for admission values, all single time point and peak hs-cTnT concentrations showed moderate to good correlations with 12-months left ventricular ejection fraction (LVEF) (r = -0.41 to -0.52, all p < 0.01) and infarct size (IS) (r = 0.50 to 0.70, all p < 0.01). Peak CK (LVEF: r = -0.45 to -0.56, IS: r = 0.61 to 0.65), peak LDH (LVEF: r = -0.51 to -0.59, IS: r = 0.54 to 0.69), and peak hs-CRP (LVEF: r = -0.32 to -0.36, IS: r = 0.31 to 0.36) were also significantly related with CMR parameters (all p < 0.05). In receiver-operator characteristic analysis, peak hs-cTnT (AUC = 0.82 (0.71 - 0.92) and 0.89 (0.81 - 0.97), respectively) and peak LDH (AUC = 0.83 (0.74 - 0.93) and 0.91 (0.84 - 0.99), respectively) displayed the best performance for prediction of reduced LVEF (< 55 %, n = 29) and large infarct size at follow-up (> 8 % of left ventricular myocardial mass, n = 36). The combination of biomarkers did not significantly improve the predictive power of hs-cTnT alone (p > 0.05).

Conclusions

In patients with first STEMI, peak concentrations of hs-cTnT are closely correlated to long-term myocardial function and infarct size. Maximum concentrations of CK, LDH, and hs-CRP were also correlated with 12-months LVEF and infarct size, but did not add any significant prognostic value compared to hs-cTnT alone.

Funding

Austrian Society of Cardiology.

Authors’ Affiliations

(1)
University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University Innsbruck, Innsbruck, Austria
(2)
Departement of Radiology I, Medical University of Innsbruck, Innsbruck, Austria

Copyright

© Reinstadler et al; licensee BioMed Central Ltd. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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