AustralieFrV1, Main, Exploration, bibRecord, 006784

Quantitative troponin and death, cardiogenic shock, cardiac arrest and new heart failure in patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS): insights from the Global Registry of Acute Coronary Events

Identifieur interne : 006784 ( Main/Exploration ); précédent : 006783; suivant : 006785

Quantitative troponin and death, cardiogenic shock, cardiac arrest and new heart failure in patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS): insights from the Global Registry of Acute Coronary Events

Auteurs : Sanjit S. Jolly [Canada] ; Heather Shenkman [États-Unis] ; David Brieger [Australie] ; Keith A. Fox [Royaume-Uni] ; Andrew T. Yan [Canada] ; Kim A. Eagle [États-Unis] ; P. Gabriel Steq [France] ; Ki-Dong Lim [Canada] ; Ann Quill [États-Unis] ; Shaun G. Goodman [Canada]

Source :

Heart : (London 1996) [ 1355-6037 ] ; 2011.

RBID : Pascal:11-0066151

Descripteurs français

Pascal (Inist)
- Arrêt cardiocirculatoire, Insuffisance cardiaque, Cardiopathie coronaire, Analyse quantitative, Troponine, Mort, Mortalité, Choc cardiogène, Etude cas, Susdécalage ST, Aigu, Artère coronaire, Appareil circulatoire, Cardiologie, Pronostic, Homme, Syndrome coronaire aigu.
Wicri :
- topic : Analyse quantitative, Mort, Mortalité, Homme.

English descriptors

KwdEn :
- Acute, Acute coronary syndrome, Cardiocirculatory arrest, Cardiogenic shock, Cardiology, Case study, Circulatory system, Coronary artery, Coronary heart disease, Death, Heart failure, Human, Mortality, Prognosis, Quantitative analysis, ST elevation, Troponin.

Abstract

Background The objective of this study was to determine if the extent of quantitative troponin elevation predicted mortality as well as in-hospital complications of cardiac arrest, new heart failure and cardiogenic shock. Design 16318 patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS) from the Global Registry of Acute Coronary Events (GRACE) were included. The maximum 24 h troponin value as a multiple of the local laboratory upper limit of normal was used. The population was divided into five groups based on the degree of troponin elevation, and outcomes were compared. An adjusted analysis was performed using quantitative troponin as a continuous variable with adjustment for known prognostic variables. Results For each approximate 10-fold increase in the troponin ratio, there was an associated increase in cardiac arrest, sustained ventricular tachycardia (VT) or ventricular fibrillation (VF) (1.0, 2.4, 3.4, 5.9 and 13.4%; p<0.001 for linear trend), cardiogenic shock (0.5, 1.4, 2.0, 4.4 and 12.7%; p<0.001), new heart failure (2.5, 5.1, 7.4, 11.6 and 15.8%; p<0.001) and mortality (0.8, 2.2, 3.0, 5.3 and 14.0%; p<0.001). These findings were replicated using the troponin ratio as a continuous variable and adjusting for covariates (cardiac arrest, sustained VT or VF, OR 1.56, 95% CI 1.39 to 1.74; cardiogenic shock, OR 1.87, 95% CI 1.61 to 2.18; and new heart failure, OR 1.57, 95% CI 1.45 to 1.71). The degree of troponin elevation was predictive of early mortality (HR 1.61, 95% CI 1.44 to 1.81; p<0.001 for days 0-14) and longer term mortality (HR 1.18, 95% CI 1.07 to 1.30, p=0.001 for days 15-180). Conclusion The extent of troponin elevation is an independent predictor of morbidity and mortality.

Affiliations:

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Le document en format XML

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<front><div type="abstract" xml:lang="en">Background The objective of this study was to determine if the extent of quantitative troponin elevation predicted mortality as well as in-hospital complications of cardiac arrest, new heart failure and cardiogenic shock. Design 16318 patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS) from the Global Registry of Acute Coronary Events (GRACE) were included. The maximum 24 h troponin value as a multiple of the local laboratory upper limit of normal was used. The population was divided into five groups based on the degree of troponin elevation, and outcomes were compared. An adjusted analysis was performed using quantitative troponin as a continuous variable with adjustment for known prognostic variables. Results For each approximate 10-fold increase in the troponin ratio, there was an associated increase in cardiac arrest, sustained ventricular tachycardia (VT) or ventricular fibrillation (VF) (1.0, 2.4, 3.4, 5.9 and 13.4%; p<0.001 for linear trend), cardiogenic shock (0.5, 1.4, 2.0, 4.4 and 12.7%; p<0.001), new heart failure (2.5, 5.1, 7.4, 11.6 and 15.8%; p<0.001) and mortality (0.8, 2.2, 3.0, 5.3 and 14.0%; p<0.001). These findings were replicated using the troponin ratio as a continuous variable and adjusting for covariates (cardiac arrest, sustained VT or VF, OR 1.56, 95% CI 1.39 to 1.74; cardiogenic shock, OR 1.87, 95% CI 1.61 to 2.18; and new heart failure, OR 1.57, 95% CI 1.45 to 1.71). The degree of troponin elevation was predictive of early mortality (HR 1.61, 95% CI 1.44 to 1.81; p<0.001 for days 0-14) and longer term mortality (HR 1.18, 95% CI 1.07 to 1.30, p=0.001 for days 15-180). Conclusion The extent of troponin elevation is an independent predictor of morbidity and mortality.</div>
</front>
</TEI>
<affiliations><list><country><li>Australie</li>
<li>Canada</li>
<li>France</li>
<li>Royaume-Uni</li>
<li>États-Unis</li>
</country>
<region><li>Californie</li>
<li>Massachusetts</li>
<li>Michigan</li>
<li>Nouvelle-Galles du Sud</li>
<li>Ontario</li>
<li>Écosse</li>
<li>Île-de-France</li>
</region>
<settlement><li>Hamilton (Ontario)</li>
<li>Paris</li>
<li>Sydney</li>
<li>Toronto</li>
<li>Édimbourg</li>
</settlement>
<orgName><li>Université McMaster</li>
<li>Université d'Édimbourg</li>
<li>Université de Toronto</li>
</orgName>
</list>
<tree><country name="Canada"><region name="Ontario"><name sortKey="Jolly, Sanjit S" sort="Jolly, Sanjit S" uniqKey="Jolly S" first="Sanjit S." last="Jolly">Sanjit S. Jolly</name>
</region>
<name sortKey="Goodman, Shaun G" sort="Goodman, Shaun G" uniqKey="Goodman S" first="Shaun G." last="Goodman">Shaun G. Goodman</name>
<name sortKey="Goodman, Shaun G" sort="Goodman, Shaun G" uniqKey="Goodman S" first="Shaun G." last="Goodman">Shaun G. Goodman</name>
<name sortKey="Lim, Ki Dong" sort="Lim, Ki Dong" uniqKey="Lim K" first="Ki-Dong" last="Lim">Ki-Dong Lim</name>
<name sortKey="Lim, Ki Dong" sort="Lim, Ki Dong" uniqKey="Lim K" first="Ki-Dong" last="Lim">Ki-Dong Lim</name>
<name sortKey="Yan, Andrew T" sort="Yan, Andrew T" uniqKey="Yan A" first="Andrew T." last="Yan">Andrew T. Yan</name>
<name sortKey="Yan, Andrew T" sort="Yan, Andrew T" uniqKey="Yan A" first="Andrew T." last="Yan">Andrew T. Yan</name>
</country>
<country name="États-Unis"><region name="Californie"><name sortKey="Shenkman, Heather" sort="Shenkman, Heather" uniqKey="Shenkman H" first="Heather" last="Shenkman">Heather Shenkman</name>
</region>
<name sortKey="Eagle, Kim A" sort="Eagle, Kim A" uniqKey="Eagle K" first="Kim A." last="Eagle">Kim A. Eagle</name>
<name sortKey="Quill, Ann" sort="Quill, Ann" uniqKey="Quill A" first="Ann" last="Quill">Ann Quill</name>
</country>
<country name="Australie"><region name="Nouvelle-Galles du Sud"><name sortKey="Brieger, David" sort="Brieger, David" uniqKey="Brieger D" first="David" last="Brieger">David Brieger</name>
</region>
</country>
<country name="Royaume-Uni"><region name="Écosse"><name sortKey="Fox, Keith A" sort="Fox, Keith A" uniqKey="Fox K" first="Keith A." last="Fox">Keith A. Fox</name>
</region>
</country>
<country name="France"><region name="Île-de-France"><name sortKey="Gabriel Steq, P" sort="Gabriel Steq, P" uniqKey="Gabriel Steq P" first="P." last="Gabriel Steq">P. Gabriel Steq</name>
</region>
</country>
</tree>
</affiliations>
</record>

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Quantitative troponin and death, cardiogenic shock, cardiac arrest and new heart failure in patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS): insights from the Global Registry of Acute Coronary Events

Quantitative troponin and death, cardiogenic shock, cardiac arrest and new heart failure in patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS): insights from the Global Registry of Acute Coronary Events

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