Elevated troponin I level on admission is associated with adverse outcome of primary angioplasty in acute myocardial...

Area of Science:

• Cardiology
• Interventional Cardiology
• Biomarkers in Cardiovascular Disease

Background:

• Elevated troponin levels in acute myocardial infarction (AMI) patients treated with thrombolysis are linked to poor outcomes.
• The predictive value of admission troponin levels in primary angioplasty for AMI is not well-established.

Purpose of the Study:

• To investigate whether elevated cardiac troponin I (cTnI) on admission predicts adverse outcomes in patients with ST-segment elevation AMI undergoing primary angioplasty.

Main Methods:

• Cardiac troponin I (cTnI) was measured on admission in 110 consecutive AMI patients undergoing primary angioplasty.
• Outcomes assessed included reperfusion rates (TIMI 3 flow), clinical complications (heart failure, death, shock), and long-term cardiac events.

Main Results:

• 49% of patients had elevated cTnI on admission.
• Elevated cTnI was associated with lower rates of achieving TIMI 3 flow (76% vs. 96%) and higher rates of congestive heart failure (23% vs. 9%).
• Elevated cTnI predicted a composite endpoint of death, heart failure, or shock (30% vs. 9%) and long-term cardiac mortality (11% vs. 0%).

Conclusions:

• In ST-segment elevation AMI patients, elevated admission cTnI is a significant predictor of primary angioplasty failure.
• Elevated cTnI is associated with a more complicated clinical course and increased long-term adverse cardiac events.