Prognostic Value of New-Generation Troponins in ST-Segment-Elevation Myocardial Infarction in the Modern Era: The RUTI-STEMI Study

Background-In ST-segment-elevation myocardial infarction (STEMI), troponins are not needed for diagnosis: symptoms and ECG data are sufficient to activate percutaneous coronary intervention. This study explored the prognostic value of new-generation troponins in a real-life cohort contemporarily tre...

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Autores: Cediel G, Rueda F, García C, Oliveras T, Labata C, Serra J, Núñez J, Bodí V, Ferrer M, Lupón J, Bayes-Genis A
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2017
País:España
Recursos:INCLIVA
Repositorio:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
OAI Identifier:oai:incliva.fundanetsuite.com:p1231
Acesso em linha:https://incliva.portalinvestigacion.com/publicaciones/1231
Access Level:acceso abierto
Palavra-chave:myocardial infarction
prognosis
ST-segment-elevation myocardial infarction
troponin
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spelling Prognostic Value of New-Generation Troponins in ST-Segment-Elevation Myocardial Infarction in the Modern Era: The RUTI-STEMI StudyCediel GRueda FGarcía COliveras TLabata CSerra JNúñez JBodí VFerrer MLupón JBayes-Genis Amyocardial infarctionprognosisST-segment-elevation myocardial infarctiontroponinBackground-In ST-segment-elevation myocardial infarction (STEMI), troponins are not needed for diagnosis: symptoms and ECG data are sufficient to activate percutaneous coronary intervention. This study explored the prognostic value of new-generation troponins in a real-life cohort contemporarily treated for STEMI. Methods and Results-We studied 1260 consecutive patients with primary STEMI treated with percutaneous coronary intervention between February 22, 2011, and August 31, 2015. We collected data on clinical characteristics and major adverse cardiovascular and cerebrovascular events (MACCEs) at 30 days and 1 year. Peak high-sensitivity troponin T and sensitive-contemporary troponin I levels were recorded. MACCEs occurred in 75 patients (6.1%) by day 30 and in 124 patients (10.8%) between day 31 and 1 year. A short-term (0-30 days) multivariable Cox regression analysis revealed that age, Killip-Kimball class, and left ventricular ejection fraction were independent predictors of MACCEs. In adjusted analysis, peak high-sensitivity troponin T and sensitive-contemporary troponin I were not significant (hazard ratio, 1.23 [95% confidence interval, 0.98-1.54] [P=0.071]; and hazard ratio, 1.15 [95% confidence interval, 0.93-1.43] [P=0.200], respectively). A long-term (31 days-1 year) multivariable Cox regression analysis revealed that age, female sex, diabetes mellitus, prior coronary artery disease, Killip-Kimball class, and left ventricular ejection fraction were statistically significantly associated with MACCEs. However, peak high-sensitivity troponin T and peak sensitive-contemporary troponin I were not significantly associated with MACCEs (hazard ratio, 1.03 [95% confidence interval, 0.88-1.20] [P= 0.715]; and hazard ratio, 0.99 [95% confidence interval, 0.85-1.15] [P= 0.856], respectively). Conclusions-In the modern era, new-generation troponins do not provide significant prognostic information for predicting clinical events in STEMI. We should reconsider the value of serial troponin measurements for risk stratification in STEMI.WILEY2017info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://incliva.portalinvestigacion.com/publicaciones/1231Journal of the American Heart AssociationISSN: 20479980reponame:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVAinstname:INCLIVAInglésinfo:eu-repo/semantics/openAccessoai:incliva.fundanetsuite.com:p12312026-06-07T16:35:31Z
dc.title.none.fl_str_mv Prognostic Value of New-Generation Troponins in ST-Segment-Elevation Myocardial Infarction in the Modern Era: The RUTI-STEMI Study
title Prognostic Value of New-Generation Troponins in ST-Segment-Elevation Myocardial Infarction in the Modern Era: The RUTI-STEMI Study
spellingShingle Prognostic Value of New-Generation Troponins in ST-Segment-Elevation Myocardial Infarction in the Modern Era: The RUTI-STEMI Study
Cediel G
myocardial infarction
prognosis
ST-segment-elevation myocardial infarction
troponin
title_short Prognostic Value of New-Generation Troponins in ST-Segment-Elevation Myocardial Infarction in the Modern Era: The RUTI-STEMI Study
title_full Prognostic Value of New-Generation Troponins in ST-Segment-Elevation Myocardial Infarction in the Modern Era: The RUTI-STEMI Study
title_fullStr Prognostic Value of New-Generation Troponins in ST-Segment-Elevation Myocardial Infarction in the Modern Era: The RUTI-STEMI Study
title_full_unstemmed Prognostic Value of New-Generation Troponins in ST-Segment-Elevation Myocardial Infarction in the Modern Era: The RUTI-STEMI Study
title_sort Prognostic Value of New-Generation Troponins in ST-Segment-Elevation Myocardial Infarction in the Modern Era: The RUTI-STEMI Study
dc.creator.none.fl_str_mv Cediel G
Rueda F
García C
Oliveras T
Labata C
Serra J
Núñez J
Bodí V
Ferrer M
Lupón J
Bayes-Genis A
author Cediel G
author_facet Cediel G
Rueda F
García C
Oliveras T
Labata C
Serra J
Núñez J
Bodí V
Ferrer M
Lupón J
Bayes-Genis A
author_role author
author2 Rueda F
García C
Oliveras T
Labata C
Serra J
Núñez J
Bodí V
Ferrer M
Lupón J
Bayes-Genis A
author2_role author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv myocardial infarction
prognosis
ST-segment-elevation myocardial infarction
troponin
topic myocardial infarction
prognosis
ST-segment-elevation myocardial infarction
troponin
description Background-In ST-segment-elevation myocardial infarction (STEMI), troponins are not needed for diagnosis: symptoms and ECG data are sufficient to activate percutaneous coronary intervention. This study explored the prognostic value of new-generation troponins in a real-life cohort contemporarily treated for STEMI. Methods and Results-We studied 1260 consecutive patients with primary STEMI treated with percutaneous coronary intervention between February 22, 2011, and August 31, 2015. We collected data on clinical characteristics and major adverse cardiovascular and cerebrovascular events (MACCEs) at 30 days and 1 year. Peak high-sensitivity troponin T and sensitive-contemporary troponin I levels were recorded. MACCEs occurred in 75 patients (6.1%) by day 30 and in 124 patients (10.8%) between day 31 and 1 year. A short-term (0-30 days) multivariable Cox regression analysis revealed that age, Killip-Kimball class, and left ventricular ejection fraction were independent predictors of MACCEs. In adjusted analysis, peak high-sensitivity troponin T and sensitive-contemporary troponin I were not significant (hazard ratio, 1.23 [95% confidence interval, 0.98-1.54] [P=0.071]; and hazard ratio, 1.15 [95% confidence interval, 0.93-1.43] [P=0.200], respectively). A long-term (31 days-1 year) multivariable Cox regression analysis revealed that age, female sex, diabetes mellitus, prior coronary artery disease, Killip-Kimball class, and left ventricular ejection fraction were statistically significantly associated with MACCEs. However, peak high-sensitivity troponin T and peak sensitive-contemporary troponin I were not significantly associated with MACCEs (hazard ratio, 1.03 [95% confidence interval, 0.88-1.20] [P= 0.715]; and hazard ratio, 0.99 [95% confidence interval, 0.85-1.15] [P= 0.856], respectively). Conclusions-In the modern era, new-generation troponins do not provide significant prognostic information for predicting clinical events in STEMI. We should reconsider the value of serial troponin measurements for risk stratification in STEMI.
publishDate 2017
dc.date.none.fl_str_mv 2017
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://incliva.portalinvestigacion.com/publicaciones/1231
url https://incliva.portalinvestigacion.com/publicaciones/1231
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv WILEY
publisher.none.fl_str_mv WILEY
dc.source.none.fl_str_mv Journal of the American Heart Association
ISSN: 20479980
reponame:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
instname:INCLIVA
instname_str INCLIVA
reponame_str r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
collection r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,81155

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