Abstract:
BACKGROUND:The long-term prognostic significance of elevated cardiac markers in an undifferentiated patient population with chest pain is unknown. METHODS:Serum troponin I (cTnI), creatine kinase-MB (CK-MB), and myoglobin were measured at presentation in 951 consecutive patients evaluated in the emergency department for possible acute coronary syndrome, and all-cause mortality was measured over 5 years. RESULTS:Final diagnoses included myocardial infarction in 70 (7.4%), unstable angina in 78 (8.2%), stable angina in 26 (2.7%), heart failure in 135 (14.2%), syncope in 61 (6.4%), arrhythmia in 62 (6.5%), and noncardiac diagnoses in 519 (54.6%). Our study population had a mean (+/-SD) age of 63 (+/-16), 434 (46%) were male, 774 (81%) were African American, 408 (43%) had known coronary artery disease, 647 (68%) had hypertension, 244 (26%) had diabetes mellitus, and 237 (25%) had a serum creatinine>or=1.5 mg/dL. At 5 years, there were 349 (36.7%) deaths. In a multivariate model with adjustment for baseline covariates, an elevated cTnI>or=1.0 ng/mL (hazard ratio [HR] 1.7, 95% CI 1.3-2.3) and myoglobin>or=200 ng/mL (HR 1.6, 95% CI 1.2-2.1), but not CK-MB>or=9.0 ng/mL (HR 0.9, 95% CI 0.6-1.3), remained independent predictors of all-cause mortality. Patients with both elevated cTnI and myoglobin had a particularly high mortality rate. CONCLUSION:Among patients evaluated in the emergency department for possible acute coronary syndromes, myoglobin and cTnI at presentation are powerful, independent predictors of long-term (5-year) prognosis.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Jaffery Z,Nowak R,Khoury N,Tokarski G,Lanfear DE,Jacobsen G,McCord Jdoi
10.1016/j.ahj.2008.06.020subject
Has Abstractpub_date
2008-11-01 00:00:00pages
939-45issue
5eissn
0002-8703issn
1097-6744pii
S0002-8703(08)00542-5journal_volume
156pub_type
杂志文章abstract::Patients experiencing out-of-hospital cardiac arrest (OHCA) without ST-segment elevation are a heterogenic group with a variety of underlying causes. Up to one-third of patients display a significant coronary lesion compatible with myocardial infarction as OHCA trigger. There are no randomized data on patient selectio...
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pub_type: 杂志文章,多中心研究,随机对照试验
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abstract:BACKGROUND:Inflammation has been suggested as a factor in the initiation and maintenance of atrial fibrillation (AF). Several observational studies have suggested that statins, presumably through their anti-inflammatory properties, decrease the risk of AF. METHODS:We analyzed 2 large, randomized trials, PROVE IT-TIMI ...
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pub_type: 杂志文章,多中心研究
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pub_type: 临床试验,杂志文章,随机对照试验
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pub_type: 杂志文章,meta分析,评审
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pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 杂志文章
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更新日期:2005-09-01 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章,评审
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