The Association between Troponin-I Clearance after the Return of Spontaneous Circulation and Outcomes in Out-of-Hospital Cardiac Arrest Patients
Background: Elevated levels of troponin-I (TnI) are common in out-of-hospital cardiac arrest (OHCA) patients. However, studies evaluating the prognostic value of TnI clearance in OHCA patients are lacking. We aimed to examine how TnI clearance (TnI-C) differed according to the neurological outcome g...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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IMR Press
2024-01-01
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| Series: | Reviews in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.imrpress.com/journal/RCM/25/1/10.31083/j.rcm2501024 |
| _version_ | 1797338502230179840 |
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| author | Dong Hun Lee Byung Kook Lee Seok Jin Ryu |
| author_facet | Dong Hun Lee Byung Kook Lee Seok Jin Ryu |
| author_sort | Dong Hun Lee |
| collection | DOAJ |
| description | Background: Elevated levels of troponin-I (TnI) are common in out-of-hospital cardiac arrest (OHCA) patients. However, studies evaluating the prognostic value of TnI clearance in OHCA patients are lacking. We aimed to examine how TnI clearance (TnI-C) differed according to the neurological outcome group and mortality group at 6 months. Methods: This retrospective observational study involved adults (≥18 years) who were treated for an OHCA between January 2019 and December 2022. The TnI-Cs were calculated for days 1 to 2 (TnI-C1st) and 2 to 3 (TnI-C2nd) after the return of spontaneous circulation (ROSC). The primary outcome was a poor neurological outcome at 6 months, defined by cerebral performance categories 3, 4, and 5. The secondary outcome was 6-month mortality. Results: A total of 227 patients were included. A poor neurological outcome and mortality at 6-months were reported in 150 (66.1%) and 118 (52.0%) patients, respectively. The TnI-C1st was significantly lower in patients with a poor outcome compared with good outcome patients (neurological outcome at 6 months, 54.4% vs. 42.3%; 6-month mortality, 52.1% vs. 42.7%, respectively). In the multivariable analyses, a TnI-C1st <50% was associated with a poor neurological outcome (odds ratio [OR] 2.078, 95% confidence interval [CI] 1.080–3.995, p = 0.028) and mortality (OR 2.131, 95% CI 1.114–4.078, p = 0.022) at 6 months. Conclusions: After ROSC, TnI-C1st <50% was associated with a poor neurological outcome and mortality at 6 months in OHCA patients. |
| first_indexed | 2024-03-08T09:32:11Z |
| format | Article |
| id | doaj.art-b0e502d3ad3044f7adb8a7761341b5cd |
| institution | Directory Open Access Journal |
| issn | 1530-6550 |
| language | English |
| last_indexed | 2024-03-08T09:32:11Z |
| publishDate | 2024-01-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Reviews in Cardiovascular Medicine |
| spelling | doaj.art-b0e502d3ad3044f7adb8a7761341b5cd2024-01-31T01:12:56ZengIMR PressReviews in Cardiovascular Medicine1530-65502024-01-012512410.31083/j.rcm2501024S1530-6550(23)01137-7The Association between Troponin-I Clearance after the Return of Spontaneous Circulation and Outcomes in Out-of-Hospital Cardiac Arrest PatientsDong Hun Lee0Byung Kook Lee1Seok Jin Ryu2Department of Emergency Medicine, Chonnam National University Hospital, 61469 Gwangju, Republic of KoreaDepartment of Emergency Medicine, Chonnam National University Hospital, 61469 Gwangju, Republic of KoreaDepartment of Emergency Medicine, Chonnam National University Hospital, 61469 Gwangju, Republic of KoreaBackground: Elevated levels of troponin-I (TnI) are common in out-of-hospital cardiac arrest (OHCA) patients. However, studies evaluating the prognostic value of TnI clearance in OHCA patients are lacking. We aimed to examine how TnI clearance (TnI-C) differed according to the neurological outcome group and mortality group at 6 months. Methods: This retrospective observational study involved adults (≥18 years) who were treated for an OHCA between January 2019 and December 2022. The TnI-Cs were calculated for days 1 to 2 (TnI-C1st) and 2 to 3 (TnI-C2nd) after the return of spontaneous circulation (ROSC). The primary outcome was a poor neurological outcome at 6 months, defined by cerebral performance categories 3, 4, and 5. The secondary outcome was 6-month mortality. Results: A total of 227 patients were included. A poor neurological outcome and mortality at 6-months were reported in 150 (66.1%) and 118 (52.0%) patients, respectively. The TnI-C1st was significantly lower in patients with a poor outcome compared with good outcome patients (neurological outcome at 6 months, 54.4% vs. 42.3%; 6-month mortality, 52.1% vs. 42.7%, respectively). In the multivariable analyses, a TnI-C1st <50% was associated with a poor neurological outcome (odds ratio [OR] 2.078, 95% confidence interval [CI] 1.080–3.995, p = 0.028) and mortality (OR 2.131, 95% CI 1.114–4.078, p = 0.022) at 6 months. Conclusions: After ROSC, TnI-C1st <50% was associated with a poor neurological outcome and mortality at 6 months in OHCA patients.https://www.imrpress.com/journal/RCM/25/1/10.31083/j.rcm2501024troponincardiac arrestprognosisclearance |
| spellingShingle | Dong Hun Lee Byung Kook Lee Seok Jin Ryu The Association between Troponin-I Clearance after the Return of Spontaneous Circulation and Outcomes in Out-of-Hospital Cardiac Arrest Patients Reviews in Cardiovascular Medicine troponin cardiac arrest prognosis clearance |
| title | The Association between Troponin-I Clearance after the Return of Spontaneous Circulation and Outcomes in Out-of-Hospital Cardiac Arrest Patients |
| title_full | The Association between Troponin-I Clearance after the Return of Spontaneous Circulation and Outcomes in Out-of-Hospital Cardiac Arrest Patients |
| title_fullStr | The Association between Troponin-I Clearance after the Return of Spontaneous Circulation and Outcomes in Out-of-Hospital Cardiac Arrest Patients |
| title_full_unstemmed | The Association between Troponin-I Clearance after the Return of Spontaneous Circulation and Outcomes in Out-of-Hospital Cardiac Arrest Patients |
| title_short | The Association between Troponin-I Clearance after the Return of Spontaneous Circulation and Outcomes in Out-of-Hospital Cardiac Arrest Patients |
| title_sort | association between troponin i clearance after the return of spontaneous circulation and outcomes in out of hospital cardiac arrest patients |
| topic | troponin cardiac arrest prognosis clearance |
| url | https://www.imrpress.com/journal/RCM/25/1/10.31083/j.rcm2501024 |
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