Prognostic implications of myocardial necrosis triad markers' concentration measured at admission in patients with suspected acute coronary syndrome

Szymański, Filip M.; Grabowski, Marcin; Filipiak‬, Krzysztof J.; Karpiński, Grzegorz; Hrynkiewicz, Anna; Stolarz, Przemysław; Oręziak, Artur; Rudowski, Robert; Opolski, Grzegorz

doi:10.1016/j.ajem.2006.07.007

Cited by 9 publications

(7 citation statements)

References 17 publications

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“…Regardless of the cause, mortality rates and neurological prognosis remain poor. 21,22 In our study first measurements of troponin I concentration were similar in non-survivors and survivors. During cardiac arrest saving human life is the priority, pushing scientific research into the background; large prospective studies to validate different CPR strategies are almost impossible to carry out due to ethical and other considerations.…”

Section: Discussionsupporting

confidence: 60%

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Prognostic value of troponin I and NT-proBNP concentrations in patients after in-hospital cardiac arrest

Płatek

Szymański

Filipiak‬

et al. 2015

Revista Portuguesa de Cardiologia (English Edition)

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Objectives: Cardiac arrest (CA) is a complex event with a dismal survival rate. The aim of this study was to determine whether N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels measured on admission and serial cardiac troponin I determination in patients with in-hospital cardiac arrest (IHCA) are predictive of 30-day mortality. Methods: Out of 9877 patients hospitalized in the cardiac intensive care unit during the study, we enrolled consecutive patients experiencing cardiac arrest within 12 hours of admission. Baseline characteristics, information about circumstances of CA and cardiopulmonary resuscitation, and initial biochemical parameters were retrospectively collected. Results: A total of 106 patients (61 male, age 71.4±12.6 years) were enrolled. Thirty-four (32.1%) had a history of myocardial infarction, and 13 (12.3%) a history of stroke. Total 30-day mortality was 60.4%. Deceased patients were older (73.7±11.9 vs. 67.8±13.0 years; p=0.01) and had lower systolic (89.4±37.0 vs. 115.0±24.0 mmHg; p=0.0001) and diastolic (53.6±24.8 vs. 66.1±15.0 mmHg; p=0.008) blood pressure on admission. Shockable initial rhythm was more often noted in the survivor group (54.8% vs. 28.1%; p=0.01). Deceased patients had higher median NT-proBNP levels (9590.0 [25---75% interquartile range (IQR), 5640.0---26 450.0] vs. 3190.0 [25---75% IQR, 973.8---5362.5] pg/ml; p=0.02) on admission. There were no differences in the first two troponin I measurements, but values were higher on the third measurement in non-survivors (98.2 [25---75% IQR, 76.4---175.8] vs. 18.7 [25---75% IQR, 5.2---50.6]; p=0.009). A.E. Platek et al. Conclusions: The survival rate of patients after in-hospital CA is poor. Deceased patients have higher NT-proBNP levels on admission, along with higher troponin I concentrations on the third measurement. Those biomarkers are useful in predicting 30-day mortality in IHCA patients. Paragem cardíaca intra-hospitalar; Troponina I; NT-proBNP; Mortalidade Valor prognóstico da troponina I e da concentração de NT-proBNP em doentes após paragem cardíaca intra-hospitalar Resumo Objetivos: A paragem cardíaca (PC) é uma patologia complexa com uma taxa de sobrevivência distal. O objetivo deste estudo foi analisar se a concentração do terminal N do peptídeo natriurético auricular do tipo B (NT-proBNP), medida na admissão, e se a determinação de troponina I cardíaca seriada em doentes com paragem cardíaca intra-hospitalar são fatores preditivos para mortalidade a 30 dias. Métodos: De 9877 doentes hospitalizados durante o estudo na unidade de cuidados intensivos, inscrevemos doentes consecutivos que passaram por paragem cardíaca nas primeiras 12 horas após o internamento. Foram inicialmente recolhidos características basais, informação sobre as circunstâncias da PC, ressuscitação cardiorrrespiratória e parâmetros bioquímicos iniciais. Resultados: Foram inscritos 106 doentes (61 homens, com 71,4±12,6 anos). Trinta e quatro (32,1%) doentes tinham antecedentes de enfarte do miocárdio e 13 (12,3%) antecedentes de acidente vascu...

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Section: Discussionsupporting

confidence: 60%

“…22 The authors concluded that this may be due to greater burdens of concomitant disease in the in-hospital group. It has been shown that in-hospital presentation of life-threatening ventricular arrhythmias is associated with worse prognosis than out-ofhospital.…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of troponin I and NT-proBNP concentrations in patients after in-hospital cardiac arrest

Płatek

Szymański

Filipiak‬

et al. 2015

Revista Portuguesa de Cardiologia (English Edition)

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“…First, to date this is the largest study focusing on low-moderate cardiac risk cPU cohort as opposed to patients with established acS. 13,15,19 the earlier studies did not always take into account either an elevated troponin value [20][21][22] or dynamic ecg changes-factors that meet automatic criteria for acS. 14 Second, the current study is derived from consecutive patients as opposed to a convenience sample 11,14,17,20 as used in previous studies thus reducing selection bias.…”

Section: Discussionmentioning

confidence: 98%

Elevated CK-MB with a Normal Troponin Does Not Predict 30-Day Adverse Cardiac Events in Emergency Department Chest Pain Observation Unit Patients

Safdar

Bezek

Sinusas

et al. 2014

Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine

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“…Predictively, studies have shown that a low CK-MB value at the time of diagnosis of AMI means a small amount of affected myocardium and therefore, the success of reperfusion therapy can be maximum, this translating into a lower rate of morbidity and mortality [24]. Clinical data from previous years' studies have shown the importance of CK-MB at admission as an independent predictor in both the short and long term [25][26][27]. Other studies have shown that not serial CK-MB values, but its increased value for a longer period (values above 124 mg/dL more than 18 h after the onset of myocardial infarction, despite the successful PCI) is correlated with subsequent cardiovascular events (reinfarctions, hospitalizations for cardiac decompensation, death) [28].…”

Section: Creatine Kinase Mbmentioning

confidence: 99%

Post-Myocardial Infarction Ventricular Remodeling Biomarkers—The Key Link between Pathophysiology and Clinic

et al. 2020

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Studies in recent years have shown increased interest in developing new methods of evaluation, but also in limiting post infarction ventricular remodeling, hoping to improve ventricular function and the further evolution of the patient. This is the point where biomarkers have proven effective in early detection of remodeling phenomena. There are six main processes that promote the remodeling and each of them has specific biomarkers that can be used in predicting the evolution (myocardial necrosis, neurohormonal activation, inflammatory reaction, hypertrophy and fibrosis, apoptosis, mixed processes). Some of the biomarkers such as creatine kinase–myocardial band (CK-MB), troponin, and N-terminal-pro type B natriuretic peptide (NT-proBNP) were so convincing that they immediately found their place in the post infarction patient evaluation protocol. Others that are related to more complex processes such as inflammatory biomarkers, atheroma plaque destabilization biomarkers, and microRNA are still being studied, but the results so far are promising. This article aims to review the markers used so far, but also the existing data on new markers that could be considered, taking into consideration the most important studies that have been conducted so far.

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Prognostic implications of myocardial necrosis triad markers' concentration measured at admission in patients with suspected acute coronary syndrome

Cited by 9 publications

References 17 publications

Prognostic value of troponin I and NT-proBNP concentrations in patients after in-hospital cardiac arrest

Prognostic value of troponin I and NT-proBNP concentrations in patients after in-hospital cardiac arrest

Elevated CK-MB with a Normal Troponin Does Not Predict 30-Day Adverse Cardiac Events in Emergency Department Chest Pain Observation Unit Patients

Post-Myocardial Infarction Ventricular Remodeling Biomarkers—The Key Link between Pathophysiology and Clinic

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