Multimarker approach for the prediction of microvascular obstruction after acute ST-segment elevation myocardial infarction: a prospective, observational study View Full Text


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Article Info

DATE

2016-11-28

AUTHORS

Hans-Josef Feistritzer, Sebastian Johannes Reinstadler, Gert Klug, Martin Reindl, Sebastian Wöhrer, Christoph Brenner, Agnes Mayr, Johannes Mair, Bernhard Metzler

ABSTRACT

BackgroundPresence of microvascular obstruction (MVO) derived from cardiac magnetic resonance (CMR) imaging is among the strongest outcome predictors after ST-segment elevation myocardial infarction (STEMI). We aimed to investigate the comparative predictive values of different biomarkers for the occurrence of MVO in a large cohort of reperfused STEMI patients.MethodsThis study included 128 STEMI patients. CMR imaging was performed within the first week after infarction to assess infarct characteristics, including MVO. Admission and peak concentrations of high-sensitivity cardiac troponin T (hs-cTnT), creatine kinase (CK), N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hs-CRP), lactate dehydrogenase (LDH), aspartate transaminase (AST) and alanine transaminase (ALT) were measured.ResultsMVO was detected in 69 patients (54%). hs-cTnT, CK, hs-CRP, LDH, AST and ALT peak concentrations showed similar prognostic value for the prediction of MVO (area under the curve (AUC) = 0.77, 0.77, 0.68, 0.79, 0.78 and 0.73, all p > 0.05), whereas the prognostic utility of NT-proBNP was weakly lower (AUC = 0.64, p < 0.05). Combination of these biomarkers did not increase predictive utility compared to hs-cTnT alone (p = 0.349).Conclusionshs-cTnT, CK, hs-CRP, LDH, AST and ALT peak concentrations provided similar prognostic value for the prediction of MVO. The prognostic utility of NT-proBNP was lower. Combining these biomarkers could not further improve predictive utility compared to hs-cTnT alone. More... »

PAGES

239

References to SciGraph publications

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  • 2009-07-07. Predicting microvascular obstruction with cardiac troponin T after acute myocardial infarction: a correlative study with contrast-enhanced magnetic resonance imaging in CLINICAL RESEARCH IN CARDIOLOGY
  • 2011-06-05. Impact of microvascular obstruction and infarct size on left ventricular remodeling in reperfused myocardial infarction: a contrast-enhanced cardiac magnetic resonance imaging study in THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING
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    http://scigraph.springernature.com/pub.10.1186/s12872-016-0415-z

    DOI

    http://dx.doi.org/10.1186/s12872-016-0415-z

    DIMENSIONS

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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/27894261


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        "description": "BackgroundPresence of microvascular obstruction (MVO) derived from cardiac magnetic resonance (CMR) imaging is among the strongest outcome predictors after ST-segment elevation myocardial infarction (STEMI). We aimed to investigate the comparative predictive values of different biomarkers for the occurrence of MVO in a large cohort of reperfused STEMI patients.MethodsThis study included 128 STEMI patients. CMR imaging was performed within the first week after infarction to assess infarct characteristics, including MVO. Admission and peak concentrations of high-sensitivity cardiac troponin T (hs-cTnT), creatine kinase (CK), N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hs-CRP), lactate dehydrogenase (LDH), aspartate transaminase (AST) and alanine transaminase (ALT) were measured.ResultsMVO was detected in 69 patients (54%). hs-cTnT, CK, hs-CRP, LDH, AST and ALT peak concentrations showed similar prognostic value for the prediction of MVO (area under the curve (AUC)\u2009=\u20090.77, 0.77, 0.68, 0.79, 0.78 and 0.73, all p\u2009>\u20090.05), whereas the prognostic utility of NT-proBNP was weakly lower (AUC\u2009=\u20090.64, p\u2009<\u20090.05). Combination of these biomarkers did not increase predictive utility compared to hs-cTnT alone (p\u2009=\u20090.349).Conclusionshs-cTnT, CK, hs-CRP, LDH, AST and ALT peak concentrations provided similar prognostic value for the prediction of MVO. The prognostic utility of NT-proBNP was lower. Combining these biomarkers could not further improve predictive utility compared to hs-cTnT alone.", 
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    30 schema:datePublishedReg 2016-11-28
    31 schema:description BackgroundPresence of microvascular obstruction (MVO) derived from cardiac magnetic resonance (CMR) imaging is among the strongest outcome predictors after ST-segment elevation myocardial infarction (STEMI). We aimed to investigate the comparative predictive values of different biomarkers for the occurrence of MVO in a large cohort of reperfused STEMI patients.MethodsThis study included 128 STEMI patients. CMR imaging was performed within the first week after infarction to assess infarct characteristics, including MVO. Admission and peak concentrations of high-sensitivity cardiac troponin T (hs-cTnT), creatine kinase (CK), N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hs-CRP), lactate dehydrogenase (LDH), aspartate transaminase (AST) and alanine transaminase (ALT) were measured.ResultsMVO was detected in 69 patients (54%). hs-cTnT, CK, hs-CRP, LDH, AST and ALT peak concentrations showed similar prognostic value for the prediction of MVO (area under the curve (AUC) = 0.77, 0.77, 0.68, 0.79, 0.78 and 0.73, all p > 0.05), whereas the prognostic utility of NT-proBNP was weakly lower (AUC = 0.64, p < 0.05). Combination of these biomarkers did not increase predictive utility compared to hs-cTnT alone (p = 0.349).Conclusionshs-cTnT, CK, hs-CRP, LDH, AST and ALT peak concentrations provided similar prognostic value for the prediction of MVO. The prognostic utility of NT-proBNP was lower. Combining these biomarkers could not further improve predictive utility compared to hs-cTnT alone.
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    37 schema:keywords C-reactive protein
    38 CMR imaging
    39 MethodsThis study
    40 N-terminal pro-B-type natriuretic peptide
    41 NT-proBNP
    42 ST-segment elevation myocardial infarction
    43 STEMI patients
    44 acute ST-segment elevation myocardial infarction
    45 admission
    46 alanine transaminase
    47 approach
    48 aspartate transaminase
    49 biomarkers
    50 cardiac magnetic resonance imaging
    51 cardiac troponin T
    52 characteristics
    53 cohort
    54 combination
    55 comparative predictive value
    56 concentration
    57 creatine kinase
    58 dehydrogenase
    59 different biomarkers
    60 elevation myocardial infarction
    61 first week
    62 high-sensitivity C-reactive protein
    63 high-sensitivity cardiac troponin T
    64 hs-CRP
    65 hs-cTnT
    66 imaging
    67 infarct characteristics
    68 infarction
    69 kinase
    70 lactate dehydrogenase
    71 large cohort
    72 magnetic resonance imaging
    73 microvascular obstruction
    74 multimarker approach
    75 myocardial infarction
    76 natriuretic peptide
    77 observational study
    78 obstruction
    79 occurrence
    80 occurrence of MVO
    81 outcome predictors
    82 patients
    83 peak concentration
    84 peptides
    85 prediction
    86 predictive utility
    87 predictive value
    88 predictors
    89 pro-B-type natriuretic peptide
    90 prognostic utility
    91 prognostic value
    92 protein
    93 resonance imaging
    94 similar prognostic value
    95 strong outcome predictor
    96 study
    97 transaminase
    98 troponin T
    99 utility
    100 values
    101 weeks
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