Therapeutics and Clinical Risk Management (Jan 2022)

Prognostic Implications of the Admission Cardiac Troponin I Levels and Door-to-Balloon Time on Clinical Outcomes in Patients with ST-Segment Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention

  • Zhao L,
  • Xin M,
  • Piao X,
  • Zhang S,
  • Li Y,
  • Cheng XW

Journal volume & issue
Vol. Volume 18
pp. 31 – 45

Abstract

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Longguo Zhao, Minglong Xin, Xianji Piao, Shengming Zhang, Yanglong Li, Xian Wu Cheng Department of Cardiology and Hypertension, Yanbian University Hospital, Yanji, Jilin, 133000, People’s Republic of ChinaCorrespondence: Xian Wu ChengDepartment of Cardiology and Hypertension, Yanbian University Hospital, 1327 Juzijie, Yanji, 133000, People’s Republic of ChinaEmail [email protected]; [email protected] XinDepartment of Cardiology and Hypertension, Yanbian University Hospital, 1327 Juzijie, Yanji, 133000, People’s Republic of ChinaEmail [email protected]: The prognostic implications of the admission cTnI level and D2B time combined on in-hospital and 1-year heart failure (HF) and mortality in STEMI patients undergoing a primary percutaneous coronary intervention (PCI) are remain uncertain.Methods and Results: We divided the consecutive 1485 STEMI patients who underwent PCI from January 2015 to October 2019 at our hospital into three groups based on their admission cTnI levels: normal group ( 90 min (> 90-D2B) and ≤ 90 min (≤ 90-D2B). During the in-hospital and 1-year follow-up periods, the incidence of composite clinical events increased significantly with the increase in the admission cTnI level (p 90-D2B group compared to the ≤ 90-D2B group (p = 0.006), but its influence disappeared in the 1-year follow-up (p > 0.05). A multivariable logistic analysis revealed that, in the ≤ 90-D2B group, with the exception of the cTnI ≥ 3 ng/mL patients, the cTnI level had no effect on in-hospital or 1-year outcomes; in > 90-D2B group, cTnI ≥ 3ng/mL increased outcomes in both periods.Conclusion: High cTnI levels (≥ 3 ng/mL) on admission are independent of the D2B time for predicting in-hospital and 1-year cardiac events in STEMI patients undergoing PCI.Keywords: cardiac troponin I, acute myocardial infarction, door-to-balloon time, cardiac death, heart failure

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