Abstract:
AIMS:The aim of this study is to simultaneously evaluate the incremental prognostic value of multiple cardiac biomarkers reflecting different underlying pathophysiological processes in a well-characterized population of patients with non-ST-segment acute coronary syndrome (NSTE-ACS). METHODS AND RESULTS:We measured cardiac troponin I (cTnI), N-terminal pro B-type natriuretic peptide (NT-proBNP), C-reactive protein, and myeloperodixase (MPO) among 4352 patients with NSTE-ACS in the MERLIN-TIMI 36 (Metabolic Efficiency With Ranolazine for Less Ischaemia in Non-ST Elevation Acute Coronary-Thrombolysis In Myocardial Infarction 36) trial and followed them for a mean of 343 days. When added individually to a multivariable model adjusted for clinical characteristics, the risk of cardiovascular (CV) death rose in a stepwise fashion with increasing quartiles of each biomarker, and when using their pre-defined cut-points [HR(adj) 2.71 (P < 0.001) for cTnI ≥0.03 ng/mL; HR(adj) 3.01 (P < 0.001) for NT-proBNP ≥400 pg/mL; HR(adj) 1.45 (P = 0.019) for high-sensitivity (hs) C-reactive protein ≥15 mg/L; and HR(adj) 1.49 (P = 0.006) for MPO ≥670 pmol/L]. After including all biomarkers, only NT-proBNP and cTnI were independently associated with CV death, and only cTnI with myocardial infarction (MI). The addition of NT-proBNP to a model adjusted for TIMI risk score incorporating cTnI significantly improved both the discrimination and re-classification of the model for CV death and heart failure (HF) while there was no such improvement after the addition of either MPO or hs-C-reactive protein. CONCLUSION:In this study of over 4300 patients presenting with NSTEACS, we found that both cTnI and NT-proBNP offer prognostic information beyond that achieved with clinical risk variables for CV death, MI, and HF. Myeloperoxidase and hs-C-reactive protein, while independently associated with some adverse CV outcomes, did not provide substantial incremental prognostic information when evaluated together with cTnI and NT-proBNP.
journal_name
Eur Heart Jjournal_title
European heart journalauthors
Scirica BM,Sabatine MS,Jarolim P,Murphy SA,de Lemos JL,Braunwald E,Morrow DAdoi
10.1093/eurheartj/ehq468subject
Has Abstractpub_date
2011-03-01 00:00:00pages
697-705issue
6eissn
0195-668Xissn
1522-9645pii
ehq468journal_volume
32pub_type
杂志文章,随机对照试验abstract:AIMS:The Tako-Tsubo cardiomyopathy (TTC) is characterized by a transient contractile dysfunction that has been assigned to excessive catecholamine levels after episodes of severe emotional or physical stress. Several studies have indicated that beta-adrenoceptor stimulation is associated with alteration in gene express...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehp240
更新日期:2009-09-01 00:00:00
abstract:AIMS:The study set out to assess the relative contributions of donor heart rate, respiration and recipient atrial contraction on the mean of pulsed wave transmitral Doppler flow indices in orthotopic heart transplant recipients. This would provide information on the theoretical usefulness of pacemaker synchronization o...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a015149
更新日期:1997-10-01 00:00:00
abstract:AIMS:Although embolic protection devices reduce complications during saphenous vein graft (SVG) stenting, adverse events still occur in approximately 10% of patients. IIb/IIIa antagonists have not been proven effective during SVG intervention. We hypothesized that adjunctive use of these agents might enhance the effica...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/eurheartj/ehi736
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND:Endocardial mapping of atrial fibrillation in humans is limited by its low resolution and by complexities in the arrhythmia and atrial anatomy. METHODS AND RESULTS:A catheter mounted non-contact multielectrode was deployed in the right atrium of 11 patients with atrial fibrillation and used to reconstruct 3...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.1999.1851
更新日期:2000-04-01 00:00:00
abstract::Chronic kidney disease (CKD) is associated with high cardiovascular risk. CKD patients exhibit a specific lipoprotein pattern termed 'uraemic dyslipidaemia', which is characterized by rather normal low-density lipoprotein cholesterol, low high-density lipoprotein cholesterol, and high triglyceride plasma levels. All t...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehaa1050
更新日期:2021-01-04 00:00:00
abstract::Cardiac hypertrophy was induced in rats either by isoprenaline treatment or by experimental abdominal aortic stenosis. In both models, the UTP content increased in the hypertrophying heart, while the ATP level remained depressed. The rate of net synthesis of uracil nucleotides, estimated by phosphate incorporation int...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/5.suppl_f.155
更新日期:1984-12-01 00:00:00
abstract:AIMS:The SHould we emergently revascularize Occluded Coronaries in cardiogenic shocK (SHOCK) Trial showed no benefit of early revascularization in patients aged >/=75 years with acute myocardial infarction and cardiogenic shock. We examined the effect of age on treatment and outcomes of patients with cardiogenic shock ...
journal_title:European heart journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s0195-668x(02)00844-8
更新日期:2003-05-01 00:00:00
abstract:AIMS:We investigated the potential influence of a moderate-to-high cardiovascular (CV) risk (CVR) (defined as a Systematic COronary Risk Evaluation model, or SCORE ≥ 4%), in the absence of an established CV disease, on the duration and cost of CV and non-CV sick leave (SL) resulting from common and occupational acciden...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/eht156
更新日期:2014-02-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehi582
更新日期:2006-01-01 00:00:00
abstract::In seven patients with re-entry tachycardias and the implanted antitachycardia device Tachylog (Siemens Elema, Sweden) the variation in the termination window related to posture and exertion was investigated. The investigations were performed on an outpatient basis utilizing the interactive pacing mode of the implante...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a062605
更新日期:1988-09-01 00:00:00
abstract:AIMS:We evaluated the feasibility and the acute performance of the everolimus-eluting bioresorbable vascular scaffolds (BVS) for the treatment of patients presenting with ST-segment elevation myocardial infarction (STEMI). METHODS AND RESULTS:The present investigation is a prospective, single-arm, single-centre study,...
journal_title:European heart journal
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doi:10.1093/eurheartj/eht546
更新日期:2014-03-01 00:00:00
abstract::The benefits of exercise are irrefutable. Individuals engaging in regular exercise have a favourable cardiovascular risk profile for coronary artery disease and reduce their risk of myocardial infarction by 50%. Exercise promotes longevity of life, reduces the risk of some malignancies, retards the onset of dementia, ...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/ehv090
更新日期:2015-06-14 00:00:00
abstract:AIMS:Women, particularly younger women, hospitalized with acute myocardial infarction have been found to have poorer prognosis than men. A large proportion of deaths due to myocardial infarction, however, occur in the pre-hospital phase. We set out to analyse age-specific sex differences in survival after myocardial in...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.2000.2368
更新日期:2001-02-01 00:00:00
abstract:AIMS:Positron emission tomography (PET) myocardial perfusion imaging (MPI) can non-invasively measure myocardial blood flow reserve (MBFR). We aimed to examine whether MBFR identifies patients with a survival benefit after revascularization, helping to guide post-test management. METHODS AND RESULTS:We examined all-ca...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehz389
更新日期:2020-02-01 00:00:00
abstract::Large-scale trials have demonstrated a consistent mortality reduction from angiotensin converting enzyme (ACE) inhibitor therapy for chronic heart failure. Nonetheless, the pharmacologic and physiologic mechanisms of this favourable affect and the appropriate target population remain controversial. ACE inhibitors exer...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/16.suppl_o.133
更新日期:1995-12-01 00:00:00
abstract:AIMS:A lack of donor hearts has stimulated interest in using blood pumps to treat severe heart failure. We tested the hypothesis that a new continuous flow circulatory assist device could be employed safely to relieve symptoms of heart failure and evaluated the potential to prolong life. METHODS AND RESULTS:An intraca...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1093/eurheartj/ehi163
更新日期:2005-05-01 00:00:00
abstract::Left ventricular pressure overload results in the development of left ventricular hypertrophy (LVH) which is considered an adaptive mechanism of the heart to normalize systolic wall-stress. Impairment of both contractility and relaxation occurs, implying that the hypertrophied myocardium is very sensitive to ischaemia...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:
更新日期:1993-11-01 00:00:00
abstract::The aim of this study was to improve the reproducibility and the standardization of the topographical assessment of myocardial infarctions in routine two-dimensional echocardiography. A myocardial map of the left ventricle was derived from a necropsy study of normal human hearts; interventricular grooves and papillary...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a061399
更新日期:1983-11-01 00:00:00
abstract:AIMS:Kinetics of recovery oxygen consumption after exercise plays an important role in determining exercise capacity. This study was performed to assess the kinetics of recovery oxygen consumption in mitral stenosis and evaluate the effects of percutaneous balloon mitral valvuloplasty and exercise training on the kinet...
journal_title:European heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1053/euhj.1998.1146
更新日期:1998-12-01 00:00:00
abstract:AIMS:Adults who engage in leisure-time physical activity (LTPA) have a reduced risk of developing heart failure. We hypothesized that high levels of LTPA are associated with diminished adverse age-related changes in cardiac structure and function. METHODS AND RESULTS:We studied 4342 Atherosclerosis Risk in Communities...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehw121
更新日期:2016-08-21 00:00:00
abstract::A series of 42 patients with chest pain but normal coronary angiograms and normal haemodynamics at rest were prospectively classified as typical angina (group 1, N = 9) or atypical angina (group 2, N = 16) or non-anginal chest pain (group 3, N = 17). All patients underwent radionuclide ventriculography and measurement...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a062119
更新日期:1986-08-01 00:00:00
abstract:AIMS:Pre-infarction angina is associated with better outcome after myocardial infarction. The aim of this study was to assess whether pre-infarction angina is associated with decreased no-reflow after coronary recanalization. METHODS AND RESULTS:Twenty-three patients underwent intracoronary myocardial contrast echocar...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.1999.1714
更新日期:1999-12-01 00:00:00
abstract::Transluminal coronary angioplasty (PTCA) is a well defined controlled model inducing regional myocardial ischaemia in man. Direct cardiac anti-ischaemic effects of anti-anginal drugs can be assessed by intracoronary injection of small doses which do not affect systemic parameters. Trimetazidine (TMZ) has recently been...
journal_title:European heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/eurheartj/14.suppl_g.6
更新日期:1993-11-01 00:00:00
abstract::The author reviews statistical methods commonly applied in economic evaluations that rely on individual patient-level data. The paper includes a review of foundational concepts, unique characteristics of health economic data, and methods developed to address them. The paper then highlights issues that should be consid...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehu174
更新日期:2014-07-01 00:00:00
abstract:AIMS:To investigate the ability of SYNTAX score and Clinical SYNTAX score (CSS) to predict very long-term outcomes in an all-comers population receiving drug-eluting stents. METHODS AND RESULTS:The SYNTAX score was retrospectively calculated in 848 patients enrolled in the SIRolimus-eluting stent compared with pacliTA...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/eurheartj/ehr369
更新日期:2011-12-01 00:00:00
abstract::After years of stagnant finances for research, moves are under way to increase research funds in Europe. ...
journal_title:European heart journal
pub_type: 杂志文章
doi:
更新日期:2011-09-01 00:00:00
abstract::Eight young healthy male subjects, members of a Himalayan expedition, underwent 24 h Holter monitoring before departure, after 1 and 4 weeks at high altitude (5000 m) and after return to sea level. At high altitude, the circadian reciprocal changes in low and high frequency (LF, HF) were absent, with no significant re...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060415
更新日期:1994-11-01 00:00:00
abstract:AIMS:To determine very long-term survival and incidence of recurrent interventions following aorto-coronary bypass surgery using venous grafts. METHODS AND RESULTS:A group of 1041 consecutive patients operated upon between 1971 and 1980 were followed for a median of 19 years (range 13-26). Peri-operative mortality was...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.1999.1867
更新日期:2000-05-01 00:00:00
abstract:AIMS:The aim of this study was to investigate the effect of Arginase I (ArgI) on plaque stabilization in unruptured atherosclerotic plaque and explore its mechanism. METHODS AND RESULTS:The atherosclerotic plaque model was established in New Zealand rabbits by balloon injury of abdominal arteries and a high cholestero...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/eht329
更新日期:2014-04-01 00:00:00
abstract::The structural properties of cardiac isomyosins from several species were compared using native gel electrophoresis, analysis of proteolytic digests, analysis of monoclonal antibody reactivity to specific proteolytic fragments on electroblots and S1 nuclease mapping with cDNA probes. The structure of specific regions ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/5.suppl_f.69
更新日期:1984-12-01 00:00:00