Cardiovascular risk and therapeutic benefit of coronary interventions for patients with unstable angina according to the troponin T status.

نویسندگان

  • C Heeschen
  • B U Goldmann
  • W Terres
  • C W Hamm
چکیده

AIMS Elevation of troponin T in patients with unstable angina is predictive of adverse outcomes. Since no advanced therapeutic concept for such high-risk patients has been established, we investigated cardiac risk prior to, during, and after coronary revascularization in patients with unstable angina stratified according to the troponin T status. METHODS AND RESULTS Out of 351 patients with unstable angina, troponin was elevated for 36% of the patients as determined by qualitative bedside tests. The patients were followed during hospitalization and 30 days after discharge for incidence of death and myocardial infarction. In troponin-positive patients, clinical symptoms were more refractory to medical treatment than in troponin-negative patients (78% vs 44%;P=0.002). Although these patients were catheterized earlier (1.6 vs 3.4 days;P=0.005) and more frequently (95% vs 69%;P<0.001), troponin-positive patients suffered a higher incidence of cardiac events prior to scheduled revascularization (death, myocardial infarction; 6.4% vs 0.4%;P<0.001). The angiogram for troponin-positive patients confirmed a more severe coronary artery disease requiring revascularization (69% vs 50%;P=0.001). Also the following coronary intervention was more complicated (death, myocardial infarction; 15.3% vs 4.8%;P=0.02). During the 30-day follow-up period, cardiac risk remained elevated for troponin-positive patients. CONCLUSIONS Troponin T rapid testing reliably identified high-risk patients with unstable angina. A higher event rate was observed prior to and particularly in association with the coronary intervention. Coronary revascularization did not abrogate the increased risk of troponin-positive patients during the 30-day follow-up.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Comparison of serum parathyroid hormone level between patients with acute myocardial infarction, unstable angina, and normal coronary function

Background: Nowadays, cardiovascular diseases (CVDs) are among the most common causes of mortalities worldwide. Parathyroid hormone (PTH) has an important role in the pathogenesis of CVDs. The aim of the current study was to compare serum PTH levels between patients with acute myocardial infarction (MI), unstable angina, and normal coronary function. Methods: This descriptive and analytic stud...

متن کامل

بررسی میزان افسردگی در بیماران مبتلا به آنژین صدری ناپایدار

Background: Depression is prevalent health concern in patients with unstable angina. Mild depressive symptoms could increase the risk of cardiac mortality after unstable angina. The purpose of the present study was to evaluate the symptoms of depression in patients with unstable angina. Materials and methods: For this descriptive study, 100 patients with unstable angina (49 females and 51 male...

متن کامل

Angiographic findings in patients with refractory unstable angina according to troponin T status.

BACKGROUND The CAPTURE (C7E3 fab AntiPlatelet Therapy in Unstable REfactory angina) trial enrolled patients with refractory unstable angina and documented a therapeutic benefit for abciximab, a platelet glycoprotein IIb/IIIa receptor antagonist, that was particularly evident in patients with elevated troponin T (TnT) levels. In the current study, we related the angiographic data to the TnT stat...

متن کامل

Elevated troponin T and C-reactive protein predict impaired outcome for 4 years in patients with refractory unstable angina, and troponin T predicts benefit of treatment with abciximab in combination with PTCA.

AIMS Treatment with the glycoprotein IIb/IIIa receptor antagonist abciximab before and during coronary intervention in refractory unstable angina improves early outcome. We collected 4-year follow-up data to assess whether this benefit is sustained. Additionally, we investigated the predictive value of baseline troponin T and CRP for long-term cardiovascular events. METHODS AND RESULTS Of 126...

متن کامل

شمارش سلول‌های سفید خون: ابزاری کارآمد برای تعیین پیش آگهی کوتاه‌مدت بیماران دچار آنژین صدری ناپایدار اولیه – یک مطالعه آینده نگر

   Background & Aim:By early detection of high-risk patients presenting in emergency departments with primary unstable angina and performing the required diagnostic and therapeutic interventions, we can decrease the mortality and morbidity of cardiovascular diseases. The aim of the present study is the evaluation of the role of White Blood Cell count as a tool in determining the short-term prog...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • European heart journal

دوره 21 14  شماره 

صفحات  -

تاریخ انتشار 2000