Relation of Cardiac Troponin I Measurements at 24 and 48 Hours to Magnetic Resonance–Determined Infarct Size in Patients With ST-Elevation Myocardial Infarction

Abstract

Levels of circulating cardiac troponin I (cTnI) or T are correlated to extent of myocardial destruction after an acute myocardial infarction. Few studies analyzing this relation have employed a second-generation cTnI assay or cardiac magnetic resonance (CMR) as the imaging end point. In this post hoc study of the Efficacy of FX06 in the Prevention of Mycoardial Reperfusion Injury (F.I.R.E.) trial, we aimed at determining the correlation between single-point cTnI measurements and CMR-estimated infarct size at 5 to 7 days and 4 months after a first-time ST-elevation myocardial infarction (STEMI) and investigating whether cTnI might provide independent prognostic information regarding infarct size at 4 months even taking into account early infarct size. Two hundred twenty-seven patients with a first-time STEMI were included in F.I.R.E. All patients received primary percutaneous coronary intervention within 6 hours from onset of symptoms. cTnI was measured at 24 and 48 hours after admission. CMR was conducted within 1 week of the index event (5 to 7 days) and at 4 months. Pearson correlations (r) for infarct size and cTnI at 24 hours were r = 0.66 (5 days) and r = 0.63 (4 months) and those for cTnI at 48 hours were r = 0.67 (5 days) and r = 0.65 (4 months). In a multiple regression analysis for predicting infarct size at 4 months (n = 141), cTnI and infarct location retained an independent prognostic role even taking into account early infarct size. In conclusion, a single-point cTnI measurement taken early after a first-time STEMI is a useful marker for infarct size and might also supplement early CMR evaluation in prediction of infarct size at 4 months.

High-sensitivity troponin-T as a prognostic marker after out-of-hospital cardiac arrest – A targeted temperature management (TTM) trial substudy

“…Furthermore, Troponin within the first days after STEMI without OHCA is associated with infarct size, left ventricular function as well as mortality in several studies [20][21][22]. However, in the present study hs-TnT did not predict death due to cardiovascular causes or multi-organ failure in the group without STEMI.…”

Transcoronary Ethanol Ablation for Recurrent Ventricular Tachycardia After Failed Catheter Ablation

“…Single-point measurement of serum troponin I in the early phase after myocardial infarction performs well for estimation of final infarct size and is a well-established prognostic marker after myocardial infarction. 15,16 In the present study, CK-MB and troponin I levels after TCEA were not related to mortality. We did not appreciate measurable change in left ventricular function after ablation, but this is difficult to assess in patients with frequent episodes of VT and without blinded review of changes in ventricular function.…”

Relationship between ST-segment resolution and anterior infarct size after primary percutaneous coronary intervention: analysis from the INFUSE-AMI trial

“…[2][3][4][5] Cardiac magnetic resonance imaging (MRI) has emerged as the technique of choice to measure infarct size and has been shown to be able to distinguish between reversible and irreversible ischaemic injury. 6 ST-segment changes on the electrocardiogram (ECG) are one of the hallmarks of acute MI.…”