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

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Germán Cediel1,2, Ferran Rueda1,2, Cosme García1,2

  • 1Heart Institute, Hospital Universitari Germans Trias i Pujol, Badalona (Barcelona), Spain.

Journal of the American Heart Association
|December 25, 2017
PubMed

Insights

New-generation troponins do not significantly predict clinical events in ST-segment-elevation myocardial infarction (STEMI) patients. These cardiac biomarkers offer limited prognostic value for risk stratification in STEMI management.

Area of Science:

  • Cardiology
  • Biomarkers
  • Clinical Research

Background:

  • Diagnosis of ST-segment-elevation myocardial infarction (STEMI) relies on symptoms and ECG, not troponins.
  • New-generation troponins are increasingly used, but their prognostic value in STEMI requires further investigation.

Purpose of the Study:

  • To evaluate the prognostic significance of new-generation troponins (high-sensitivity troponin T and sensitive-contemporary troponin I) in a real-world STEMI cohort.
  • To determine if peak troponin levels predict major adverse cardiovascular and cerebrovascular events (MACCEs) in STEMI patients treated with percutaneous coronary intervention.

Main Methods:

  • A cohort of 1260 STEMI patients treated with percutaneous coronary intervention was analyzed.
  • Clinical data, peak high-sensitivity troponin T, and sensitive-contemporary troponin I levels were collected.
  • Multivariable Cox regression was used to assess predictors of MACCEs at 30 days and 1 year.

Main Results:

  • Age, Killip-Kimball class, and left ventricular ejection fraction were independent predictors of short-term MACCEs.
  • Neither peak high-sensitivity troponin T nor sensitive-contemporary troponin I levels were significant predictors of short-term or long-term MACCEs.
  • Long-term MACCEs were associated with age, female sex, diabetes, prior coronary artery disease, Killip-Kimball class, and LVEF.

Conclusions:

  • New-generation troponins do not provide significant prognostic information for predicting clinical events in STEMI.
  • The utility of serial troponin measurements for risk stratification in STEMI should be reconsidered.
Abstract

Keywords:
ST‐segment–elevation myocardial infarctionmyocardial infarctionprognosistroponin

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