Untangling the relationship between hemoglobin, peak troponin level, and mortality in patients with myocardial infarction
Patients with a history of myocardial infarction (MI) and lower admission hemoglobin (aHb) levels have a worse outcome than patients with higher aHb, but lower or similar peaks in enzymatic infarct size. Hemoglobin levels are positively correlated with body surface area (BSA), which is positively c...
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| Format: | Article |
| Language: | English |
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Association of Basic Medical Sciences of Federation of Bosnia and Herzegovina
2022-09-01
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| Series: | Biomolecules & Biomedicine |
| Subjects: | |
| Online Access: | https://www.bjbms.org/ojs/index.php/bjbms/article/view/6744 |
| _version_ | 1797261284810424320 |
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| author | Vojko Kanic Gregor Kompara David Suran Nina Glavnik Poznic |
| author_facet | Vojko Kanic Gregor Kompara David Suran Nina Glavnik Poznic |
| author_sort | Vojko Kanic |
| collection | DOAJ |
| description |
Patients with a history of myocardial infarction (MI) and lower admission hemoglobin (aHb) levels have a worse outcome than patients with higher aHb, but lower or similar peaks in enzymatic infarct size. Hemoglobin levels are positively correlated with body surface area (BSA), which is positively correlated with cardiac mass. We hypothesized that patients with lower aHb suffer comparatively greater myocardial injury. We examined the relationships between aHb, and troponin (Tn) normalized to BSA (Tn/BSA) and its association with 30-day mortality. Data from 6055 patients, who were divided into seven groups based on their aHb at 10g/L intervals, were analyzed, and the groups were compared. The relationships between aHb and Tn/BSA and between Tn/BSA and 30-day mortality were assessed. Patients with higher aHb levels had greater BSA (p<0.0001). A negative relationship between aHb and log10Tn/BSA was observed in the entire group, and in men and women separately (p<0.0001, p<0.0001, and p=0.013, respectively). The log10Tn/BSA value was associated with 30-day mortality in the entire group, and in men and women separately (p<0.0001, p=0.014, and p<0.0001, respectively). Our finding suggests that a similar peak Tn value in patients with lower aHb means comparatively greater myocardial injury relative to cardiac mass. This hypothesis helps to explain the worse outcomes in patients with lower aHb. According to our findings, troponin should be indexed to BSA to provide comparable information on cardiac injury relative to cardiac mass. Whether this relationship is causal remains to be clarified.
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| first_indexed | 2024-04-24T23:38:47Z |
| format | Article |
| id | doaj.art-315ffada33b5490fbd89fb286f50229c |
| institution | Directory Open Access Journal |
| issn | 2831-0896 2831-090X |
| language | English |
| last_indexed | 2024-04-24T23:38:47Z |
| publishDate | 2022-09-01 |
| publisher | Association of Basic Medical Sciences of Federation of Bosnia and Herzegovina |
| record_format | Article |
| series | Biomolecules & Biomedicine |
| spelling | doaj.art-315ffada33b5490fbd89fb286f50229c2024-03-15T13:31:03ZengAssociation of Basic Medical Sciences of Federation of Bosnia and HerzegovinaBiomolecules & Biomedicine2831-08962831-090X2022-09-0122510.17305/bjbms.2021.6744Untangling the relationship between hemoglobin, peak troponin level, and mortality in patients with myocardial infarctionVojko Kanic0https://orcid.org/0000-0001-9239-2133Gregor Kompara1https://orcid.org/0000-0001-9877-2938David Suran2https://orcid.org/0000-0002-4073-9286Nina Glavnik Poznic3https://orcid.org/0000-0002-4988-7963University Medical Center Maribor, Maribor, SloveniaUniversity Medical Center Maribor, Maribor, SloveniaUniversity Medical Center Maribor, Maribor, SloveniaUniversity Medical Center Maribor, Maribor, Slovenia Patients with a history of myocardial infarction (MI) and lower admission hemoglobin (aHb) levels have a worse outcome than patients with higher aHb, but lower or similar peaks in enzymatic infarct size. Hemoglobin levels are positively correlated with body surface area (BSA), which is positively correlated with cardiac mass. We hypothesized that patients with lower aHb suffer comparatively greater myocardial injury. We examined the relationships between aHb, and troponin (Tn) normalized to BSA (Tn/BSA) and its association with 30-day mortality. Data from 6055 patients, who were divided into seven groups based on their aHb at 10g/L intervals, were analyzed, and the groups were compared. The relationships between aHb and Tn/BSA and between Tn/BSA and 30-day mortality were assessed. Patients with higher aHb levels had greater BSA (p<0.0001). A negative relationship between aHb and log10Tn/BSA was observed in the entire group, and in men and women separately (p<0.0001, p<0.0001, and p=0.013, respectively). The log10Tn/BSA value was associated with 30-day mortality in the entire group, and in men and women separately (p<0.0001, p=0.014, and p<0.0001, respectively). Our finding suggests that a similar peak Tn value in patients with lower aHb means comparatively greater myocardial injury relative to cardiac mass. This hypothesis helps to explain the worse outcomes in patients with lower aHb. According to our findings, troponin should be indexed to BSA to provide comparable information on cardiac injury relative to cardiac mass. Whether this relationship is causal remains to be clarified. https://www.bjbms.org/ojs/index.php/bjbms/article/view/6744baseline hemoglobinmyocardial infarctionmyocardial injuryinfarct sizepercutaneus coronary interventionbody surface area |
| spellingShingle | Vojko Kanic Gregor Kompara David Suran Nina Glavnik Poznic Untangling the relationship between hemoglobin, peak troponin level, and mortality in patients with myocardial infarction Biomolecules & Biomedicine baseline hemoglobin myocardial infarction myocardial injury infarct size percutaneus coronary intervention body surface area |
| title | Untangling the relationship between hemoglobin, peak troponin level, and mortality in patients with myocardial infarction |
| title_full | Untangling the relationship between hemoglobin, peak troponin level, and mortality in patients with myocardial infarction |
| title_fullStr | Untangling the relationship between hemoglobin, peak troponin level, and mortality in patients with myocardial infarction |
| title_full_unstemmed | Untangling the relationship between hemoglobin, peak troponin level, and mortality in patients with myocardial infarction |
| title_short | Untangling the relationship between hemoglobin, peak troponin level, and mortality in patients with myocardial infarction |
| title_sort | untangling the relationship between hemoglobin peak troponin level and mortality in patients with myocardial infarction |
| topic | baseline hemoglobin myocardial infarction myocardial injury infarct size percutaneus coronary intervention body surface area |
| url | https://www.bjbms.org/ojs/index.php/bjbms/article/view/6744 |
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