https://observatorio.fm.usp.br/handle/OPI/31613
Title: | Elevated High-Sensitivity Troponin I in the Stabilized Phase after an Acute Coronary Syndrome Predicts All-Cause and Cardiovascular Mortality in a Highly Admixed Population: A 7-Year Cohort |
Authors: | CASTRO, Leandro Teixeira de; SANTOS, Itamar de Souza; GOULART, Alessandra C.; PEREIRA, Alexandre da Costa; STANIAK, Henrique Lane; BITTENCOURT, Marcio Sommer; LOTUFO, Paulo Andrade; BENSENOR, Isabela Martins |
Citation: | ARQUIVOS BRASILEIROS DE CARDIOLOGIA, v.112, n.3, p.230-237, 2019 |
Abstract: | Background: High-sensitivity cardiac troponin I (hs-cTnl) has played an important role in the risk stratification of patients during the in-hospital phase of acute coronary syndrome (ACS), but few studies have determined its role as a long-term prognostic marker in the outpatient setting. Obiective : To investigate the association between levels of hs-cTnl measured in the subacute phase after an ACS event and long-term prognosis in a highly admixed population. Methods: We measured levels of hs-cTnl in 525 patients 25 to 90 days after admission for an ACS event; these patients were then divided into tertiles according to hs-cTnl levels and followed for up to 7 years. We compared all-cause and cardiovascular mortality using Cox proportional hazards models and adopting a significance level of 5%. Results: After a median follow-up of 51 months, patients in the highest tertile had a greater hazard ratio (HR) for all-cause mortality after adjustment for age, sex, known cardiovascular risk factors, medication use, and demographic factors (HR: 3.84, 95% Cl: 1.92-8.12). These findings persisted after further adjustment for estimated glomerular filtration rate < 60 ml/min/1.73 m(2) and left ventricular ejection fraction < 0.40 (HR: 6.53, 95% CI: 2.12-20.14). Cardiovascular mortality was significantly higher in the highest tertile after adjustment for age and sex (HR: 5.65, 95% CI: 1.94-16.47) and both in the first (HR: 4.90, 95% CI: 1.35-17.82) and second models of multivariate adjustment (HR: 5.89, 95% CI: 1.08-32.27). Conclusions: Elevated hs-cTnl levels measured in the stabilized phase after an ACS event are independent predictors of all-cause and cardiovascular mortality in a highly admixed population. |
Appears in Collections: | Artigos e Materiais de Revistas Científicas - FM/MCM Artigos e Materiais de Revistas Científicas - HC/ICESP Artigos e Materiais de Revistas Científicas - HC/InCor Artigos e Materiais de Revistas Científicas - HU Artigos e Materiais de Revistas Científicas - LIM/13 Artigos e Materiais de Revistas Científicas - LIM/20 Artigos e Materiais de Revistas Científicas - LIM/51 Artigos e Materiais de Revistas Científicas - ODS/03 |
File | Description | Size | Format | |
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art_CASTRO_Elevated_HighSensitivity_Troponin_I_in_the_Stabilized_Phase_2019_eng.PDF | publishedVersion (English) | 306.11 kB | Adobe PDF | View/Open |
art_CASTRO_Elevated_HighSensitivity_Troponin_I_in_the_Stabilized_Phase_2019_por.PDF | publishedVersion (Portuguese) | 351.22 kB | Adobe PDF | View/Open |
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