High-sensitivity cardiac troponin I predict death and hospitalization at 1 year in patients assisting for a suspected acute cardiovascular condition: prospective cohort in a middle-income country

ABSTRACT: Introduction and Objectives: High sensitivity cardiac troponin (Hs-cTn) are specific biomarkers of myocardial injury. Besides diagnostic purposes, its use has been recommended for risk stratification. Most studies have evaluated the role of Hs-cTn T in prognosis estimation but there are few studies evaluating the performance of Hs-cTn I. Methods: We prospectively included patients assisting with a suspected acute cardiovascular condition. All patients have a Hs-cTn I measurement. Telephone-based interviews were performed at 3, 6, and 12 months. Medical chart review, telephonic follow-up, and national statistical system were used for event adjudication. A multivariable analysis, Kaplan Meier curves, and Cox proportional-hazards regression model were performed. Results: We include 555 patients. Mean age was 63 years and 56.8% were male. The most frequent diagnosis after hospitalization were acute coronary syndromes (29.7%) and non-specific chest pain (28.6%). Hs-cTn I was > 99th percentile in 44.5% of cases. At 1 year the primary outcome occurred more frequently in Hs-cTn I > 99th percentile group (HR 1.99, 95% CI 1.5 – 2.64; p< 0.001 (Figure 1). We found a linear relationship between primary outcome and the first Hs-cTn I concentration (Figure 2). In multivariable analysis, Hs-cTn I > 99th was independently associated with the primary outcome (OR 2.25, 95% CI 1.27 – 3.98; p = 0.05). Conclusions: Beyond diagnosis use, Hs-cTn I has a relevant role in risk stratification of patients with suspected acute cardiovascular conditions. The first Hs-cTnI value obtained in the emergency room has an independent association with primary outcome at 1 year.

• Autores: Giraldo Ramírez, Santiago
• Tipo de recurso: Tesis
• Fecha de publicación: 2021
• Institución: Universidad de Antioquia
• Repositorio: Repositorio UdeA
• Idioma: eng
• OAI Identifier: oai:bibliotecadigital.udea.edu.co:10495/20933
• Acceso en línea: http://hdl.handle.net/10495/20933
• Palabra clave: Troponina; Pronóstico; Enfermedades cardiovasculares; Biomarcadores; Troponin; Prognosis; Cardiovascular diseases; Biomarkers; http://id.nlm.nih.gov/mesh/D014336; http://id.nlm.nih.gov/mesh/D011379; http://id.nlm.nih.gov/mesh/D002318; http://id.nlm.nih.gov/mesh/D015415
• Rights: embargoedAccess
• License: http://creativecommons.org/licenses/by-nc-nd/2.5/co/