Abstract:
BACKGROUND:The associations between high-sensitivity troponin I (hsTnI) levels and coronary artery disease (CAD) severity and progression remain unclear. We investigated whether there is an association between hsTnI and angiographic severity and progression of CAD and whether the predictive value of hsTnI level for incident cardiovascular outcomes is independent of CAD severity. METHODS AND RESULTS:In 3087 patients (aged 63±12 years, 64% men) undergoing cardiac catheterization without evidence of acute myocardial infarction, the severity of CAD was calculated by the number of major coronary arteries with ≥50% stenosis and the Gensini score. CAD progression was assessed in a subset of 717 patients who had undergone ≥2 coronary angiograms >3 months before enrollment. Patients were followed up for incident all-cause mortality and incident cardiovascular events. Of the total population, 11% had normal angiograms, 23% had nonobstructive CAD, 20% had 1-vessel CAD, 20% had 2-vessel CAD, and 26% had 3-vessel CAD. After adjusting for age, sex, race, body mass index, smoking, hypertension, diabetes mellitus history, and renal function, hsTnI levels were independently associated with the severity of CAD measured by the Gensini score (log 2 ß=0.31; 95% confidence interval, 0.18-0.44; P<0.001) and with CAD progression (log 2 ß=0.36; 95% confidence interval, 0.14-0.58; P=0.001). hsTnI level was also a significant predictor of incident death, cardiovascular death, myocardial infarction, revascularization, and cardiac hospitalizations, independent of the aforementioned covariates and CAD severity. CONCLUSIONS:Higher hsTnI levels are associated with the underlying burden of coronary atherosclerosis, more rapid progression of CAD, and higher risk of all-cause mortality and incident cardiovascular events. Whether more aggressive treatment aimed at reducing hsTnI levels can modulate disease progression requires further investigation.
journal_name
J Am Heart Assocjournal_title
Journal of the American Heart Associationauthors
Samman Tahhan A,Sandesara P,Hayek SS,Hammadah M,Alkhoder A,Kelli HM,Topel M,O'Neal WT,Ghasemzadeh N,Ko YA,Gafeer MM,Abdelhadi N,Choudhary F,Patel K,Beshiri A,Murtagh G,Kim J,Wilson P,Shaw L,Vaccarino V,Epstein SEdoi
10.1161/JAHA.117.007914subject
Has Abstractpub_date
2018-02-21 00:00:00issue
5issn
2047-9980pii
JAHA.117.007914journal_volume
7pub_type
杂志文章abstract:BACKGROUND:Healthcare resources vary geographically, but associations between hospital-based resources and acute stroke quality and outcomes remain unclear. METHODS AND RESULTS:Using Get With The Guidelines-Stroke and Dartmouth Atlas of Health Care data, we examined associations between healthcare resource availabilit...
journal_title:Journal of the American Heart Association
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doi:10.1161/JAHA.116.003813
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abstract::Background Acute type A aortic dissection presents with abrupt onset of pain that requires emergency surgery. However, minimal research exists on posttraumatic stress disorder (PTSD) in survivors. We aimed to quantify the prevalence and describe characteristics of PTSD in patients following dissection. Methods and Res...
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doi:10.1161/JAHA.116.004588
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abstract::Background Pregnancy increases the risk of acute myocardial infarction (AMI). The purpose of this study was to examine timing and risk factors for AMI in pregnancy and poor outcome. Methods and Results National Inpatient Sample (2003-2015) was screened in pregnancy, labor and delivery, and postpartum. There were 11 29...
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abstract::See Article by Fudim et al. ...
journal_title:Journal of the American Heart Association
pub_type: 评论,社论
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更新日期:2018-12-18 00:00:00
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pub_type: 杂志文章,随机对照试验
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