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
Abstract Background: High-sensitivity cardiac troponin I (hs-cTnI) 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....
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Cardiologia (SBC)
2019-01-01
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| Series: | Arquivos Brasileiros de Cardiologia |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2019005022104&lng=en&tlng=en |
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| author | Leandro Teixeira de Castro Itamar de Souza Santos Alessandra C. Goulart Alexandre da Costa Pereira Henrique Lane Staniak Marcio Sommer Bittencourt Paulo Andrade Lotufo Isabela Martins Bensenor |
| author_facet | Leandro Teixeira de Castro Itamar de Souza Santos Alessandra C. Goulart Alexandre da Costa Pereira Henrique Lane Staniak Marcio Sommer Bittencourt Paulo Andrade Lotufo Isabela Martins Bensenor |
| author_sort | Leandro Teixeira de Castro |
| collection | DOAJ |
| description | Abstract Background: High-sensitivity cardiac troponin I (hs-cTnI) 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. Objective: To investigate the association between levels of hs-cTnI measured in the subacute phase after an ACS event and long-term prognosis in a highly admixed population. Methods: We measured levels of hs-cTnI in 525 patients 25 to 90 days after admission for an ACS event; these patients were then divided into tertiles according to hs-cTnI 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% CI: 1.92-8.12). These findings persisted after further adjustment for estimated glomerular filtration rate < 60 ml/min/1.73 m2 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-cTnI levels measured in the stabilized phase after an ACS event are independent predictors of all-cause and cardiovascular mortality in a highly admixed population. |
| first_indexed | 2024-12-11T18:11:09Z |
| format | Article |
| id | doaj.art-da79f421d114407f957a9741857a390c |
| institution | Directory Open Access Journal |
| issn | 1678-4170 |
| language | English |
| last_indexed | 2024-12-11T18:11:09Z |
| publishDate | 2019-01-01 |
| publisher | Sociedade Brasileira de Cardiologia (SBC) |
| record_format | Article |
| series | Arquivos Brasileiros de Cardiologia |
| spelling | doaj.art-da79f421d114407f957a9741857a390c2022-12-22T00:55:35ZengSociedade Brasileira de Cardiologia (SBC)Arquivos Brasileiros de Cardiologia1678-41702019-01-01010.5935/abc.20180268S0066-782X2019005022104Elevated 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 CohortLeandro Teixeira de CastroItamar de Souza SantosAlessandra C. GoulartAlexandre da Costa PereiraHenrique Lane StaniakMarcio Sommer BittencourtPaulo Andrade LotufoIsabela Martins BensenorAbstract Background: High-sensitivity cardiac troponin I (hs-cTnI) 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. Objective: To investigate the association between levels of hs-cTnI measured in the subacute phase after an ACS event and long-term prognosis in a highly admixed population. Methods: We measured levels of hs-cTnI in 525 patients 25 to 90 days after admission for an ACS event; these patients were then divided into tertiles according to hs-cTnI 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% CI: 1.92-8.12). These findings persisted after further adjustment for estimated glomerular filtration rate < 60 ml/min/1.73 m2 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-cTnI levels measured in the stabilized phase after an ACS event are independent predictors of all-cause and cardiovascular mortality in a highly admixed population.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2019005022104&lng=en&tlng=enDoença da Artéria Coronariana / mortalidadeTroponina IPrognósticoSíndrome MetabólicaVariação Biológica da PopulaçãoFatores de Risco |
| spellingShingle | Leandro Teixeira de Castro Itamar de Souza Santos Alessandra C. Goulart Alexandre da Costa Pereira Henrique Lane Staniak Marcio Sommer Bittencourt Paulo Andrade Lotufo Isabela Martins Bensenor 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 Arquivos Brasileiros de Cardiologia Doença da Artéria Coronariana / mortalidade Troponina I Prognóstico Síndrome Metabólica Variação Biológica da População Fatores de Risco |
| 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | Doença da Artéria Coronariana / mortalidade Troponina I Prognóstico Síndrome Metabólica Variação Biológica da População Fatores de Risco |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2019005022104&lng=en&tlng=en |
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