Serum amyloid A predicts early mortality in acute coronary syndromes: a TIMI 11A substudy
OBJECTIVES We evaluated the ability of serum amyloid A (SAA), alone and in combination with a rapid qualitative assay for cardiac-specific troponin T (cTnT), to predict 14-day mortality in patients with unstable angina or non-Q wave myocardial infarction (NQMI). BACKGROUND Elevated C-reactive protei...
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| Veröffentlicht in: | Journal of the American College of Cardiology 2000-02, Vol.35 (2), p.358-362 |
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| creator | Morrow, David A Rifai, Nader Antman, Elliott M Weiner, Debra L McCabe, Carolyn H Cannon, Christopher P Braunwald, Eugene |
| description | OBJECTIVES
We evaluated the ability of serum amyloid A (SAA), alone and in combination with a rapid qualitative assay for cardiac-specific troponin T (cTnT), to predict 14-day mortality in patients with unstable angina or non-Q wave myocardial infarction (NQMI).
BACKGROUND
Elevated C-reactive protein (CRP) has been associated with adverse outcomes in unstable coronary syndromes but data regarding its acute phase counterpart, SAA, are conflicting.
METHODS
Serum amyloid A measurement and a rapid cTnT assay were performed on blood obtained at enrollment into Thrombolysis in Myocardial Infarction 11A, a dose-ranging trial of enoxaparin for unstable angina and NQMI.
RESULTS
Serum amyloid A was higher in patients who died compared with survivors (6.28 vs. 0.75 mg/dL, p = 0.002). Among patients with a negative rapid cTnT, mortality was higher for those in the top quintile of SAA (6.1 vs. 0.7%, p = 0.003). Patients with both an early positive rapid cTnT (≤10 min until assay positive) and SAA in the fifth quintile had the highest mortality followed by those with either markedly elevated SAA or an early positive rapid cTnT, while patients with both a negative rapid cTnT and SAA in quintiles 1–4 were at very low risk, (9.1 vs. 3.6 vs. 0.7%, p |
| doi_str_mv | 10.1016/S0735-1097(99)00574-4 |
| format | Article |
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We evaluated the ability of serum amyloid A (SAA), alone and in combination with a rapid qualitative assay for cardiac-specific troponin T (cTnT), to predict 14-day mortality in patients with unstable angina or non-Q wave myocardial infarction (NQMI).
BACKGROUND
Elevated C-reactive protein (CRP) has been associated with adverse outcomes in unstable coronary syndromes but data regarding its acute phase counterpart, SAA, are conflicting.
METHODS
Serum amyloid A measurement and a rapid cTnT assay were performed on blood obtained at enrollment into Thrombolysis in Myocardial Infarction 11A, a dose-ranging trial of enoxaparin for unstable angina and NQMI.
RESULTS
Serum amyloid A was higher in patients who died compared with survivors (6.28 vs. 0.75 mg/dL, p = 0.002). Among patients with a negative rapid cTnT, mortality was higher for those in the top quintile of SAA (6.1 vs. 0.7%, p = 0.003). Patients with both an early positive rapid cTnT (≤10 min until assay positive) and SAA in the fifth quintile had the highest mortality followed by those with either markedly elevated SAA or an early positive rapid cTnT, while patients with both a negative rapid cTnT and SAA in quintiles 1–4 were at very low risk, (9.1 vs. 3.6 vs. 0.7%, p <0.002).
CONCLUSIONS
Similar to CRP, baseline elevation of SAA identifies patients hospitalized with unstable angina and NQMI at higher risk for early mortality, even among those with a negative rapid assay for cTnT. These data support further investigation of inflammatory markers used alone and in combination with cardiac troponins for risk assessment in unstable coronary syndromes.</description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/S0735-1097(99)00574-4</identifier><identifier>PMID: 10676681</identifier><identifier>CODEN: JACCDI</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Angina, Unstable - blood ; Angina, Unstable - drug therapy ; Angina, Unstable - mortality ; Apolipoproteins - metabolism ; Biological and medical sciences ; Biomarkers - blood ; Cardiology. Vascular system ; Coronary heart disease ; Electrocardiography ; Female ; Fibrinolytic Agents - therapeutic use ; Heart ; Humans ; Male ; Medical sciences ; Middle Aged ; Prognosis ; Protein Precursors - blood ; Serum Amyloid A Protein - metabolism ; Survival Rate ; Thrombolytic Therapy</subject><ispartof>Journal of the American College of Cardiology, 2000-02, Vol.35 (2), p.358-362</ispartof><rights>2000 American College of Cardiology</rights><rights>2000 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c490t-e58243baab8a7048af14b8fdc4ba6c7c96766575883a8fb84f1a1d509df93d583</citedby><cites>FETCH-LOGICAL-c490t-e58243baab8a7048af14b8fdc4ba6c7c96766575883a8fb84f1a1d509df93d583</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0735-1097(99)00574-4$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1270282$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10676681$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Morrow, David A</creatorcontrib><creatorcontrib>Rifai, Nader</creatorcontrib><creatorcontrib>Antman, Elliott M</creatorcontrib><creatorcontrib>Weiner, Debra L</creatorcontrib><creatorcontrib>McCabe, Carolyn H</creatorcontrib><creatorcontrib>Cannon, Christopher P</creatorcontrib><creatorcontrib>Braunwald, Eugene</creatorcontrib><title>Serum amyloid A predicts early mortality in acute coronary syndromes: a TIMI 11A substudy</title><title>Journal of the American College of Cardiology</title><addtitle>J Am Coll Cardiol</addtitle><description>OBJECTIVES
We evaluated the ability of serum amyloid A (SAA), alone and in combination with a rapid qualitative assay for cardiac-specific troponin T (cTnT), to predict 14-day mortality in patients with unstable angina or non-Q wave myocardial infarction (NQMI).
BACKGROUND
Elevated C-reactive protein (CRP) has been associated with adverse outcomes in unstable coronary syndromes but data regarding its acute phase counterpart, SAA, are conflicting.
METHODS
Serum amyloid A measurement and a rapid cTnT assay were performed on blood obtained at enrollment into Thrombolysis in Myocardial Infarction 11A, a dose-ranging trial of enoxaparin for unstable angina and NQMI.
RESULTS
Serum amyloid A was higher in patients who died compared with survivors (6.28 vs. 0.75 mg/dL, p = 0.002). Among patients with a negative rapid cTnT, mortality was higher for those in the top quintile of SAA (6.1 vs. 0.7%, p = 0.003). Patients with both an early positive rapid cTnT (≤10 min until assay positive) and SAA in the fifth quintile had the highest mortality followed by those with either markedly elevated SAA or an early positive rapid cTnT, while patients with both a negative rapid cTnT and SAA in quintiles 1–4 were at very low risk, (9.1 vs. 3.6 vs. 0.7%, p <0.002).
CONCLUSIONS
Similar to CRP, baseline elevation of SAA identifies patients hospitalized with unstable angina and NQMI at higher risk for early mortality, even among those with a negative rapid assay for cTnT. These data support further investigation of inflammatory markers used alone and in combination with cardiac troponins for risk assessment in unstable coronary syndromes.</description><subject>Angina, Unstable - blood</subject><subject>Angina, Unstable - drug therapy</subject><subject>Angina, Unstable - mortality</subject><subject>Apolipoproteins - metabolism</subject><subject>Biological and medical sciences</subject><subject>Biomarkers - blood</subject><subject>Cardiology. Vascular system</subject><subject>Coronary heart disease</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Fibrinolytic Agents - therapeutic use</subject><subject>Heart</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Prognosis</subject><subject>Protein Precursors - blood</subject><subject>Serum Amyloid A Protein - metabolism</subject><subject>Survival Rate</subject><subject>Thrombolytic Therapy</subject><issn>0735-1097</issn><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkMtKxDAUhoMoOl4eQclCRBfVZJo0iRsZxMuA4kJduAqnSQqRthmTVujb23EGdefqnMX3n8uH0CEl55TQ4uKZiJxnlChxqtQZIVywjG2gCeVcZjlXYhNNfpAdtJvSOyGkkFRtox1KClGM_QS9PbvYNxiaoQ7e4hleRGe96RJ2EOsBNyF2UPtuwL7FYPrOYRNiaCEOOA2tjaFx6RIDfpk_zjGlM5z6MnW9HfbRVgV1cgfruodeb29eru-zh6e7-fXsITNMkS5zXE5ZXgKUEgRhEirKSllZw0oojDBqeSkXXMocZFVKVlGglhNlK5VbLvM9dLKau4jho3ep041PxtU1tC70SQui6IixEeQr0MSQUnSVXkTfjI9oSvTSqf52qpfCtFL626le5o7WC_qycfZPaiVxBI7XACQDdRWhNT79clNBpnI6YlcrzI02Pr2LOhnvWjP6js502gb_zyVfJliS2Q</recordid><startdate>20000201</startdate><enddate>20000201</enddate><creator>Morrow, David A</creator><creator>Rifai, Nader</creator><creator>Antman, Elliott M</creator><creator>Weiner, Debra L</creator><creator>McCabe, Carolyn H</creator><creator>Cannon, Christopher P</creator><creator>Braunwald, Eugene</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20000201</creationdate><title>Serum amyloid A predicts early mortality in acute coronary syndromes: a TIMI 11A substudy</title><author>Morrow, David A ; Rifai, Nader ; Antman, Elliott M ; Weiner, Debra L ; McCabe, Carolyn H ; Cannon, Christopher P ; Braunwald, Eugene</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c490t-e58243baab8a7048af14b8fdc4ba6c7c96766575883a8fb84f1a1d509df93d583</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Angina, Unstable - blood</topic><topic>Angina, Unstable - drug therapy</topic><topic>Angina, Unstable - mortality</topic><topic>Apolipoproteins - metabolism</topic><topic>Biological and medical sciences</topic><topic>Biomarkers - blood</topic><topic>Cardiology. Vascular system</topic><topic>Coronary heart disease</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>Fibrinolytic Agents - therapeutic use</topic><topic>Heart</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Prognosis</topic><topic>Protein Precursors - blood</topic><topic>Serum Amyloid A Protein - metabolism</topic><topic>Survival Rate</topic><topic>Thrombolytic Therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Morrow, David A</creatorcontrib><creatorcontrib>Rifai, Nader</creatorcontrib><creatorcontrib>Antman, Elliott M</creatorcontrib><creatorcontrib>Weiner, Debra L</creatorcontrib><creatorcontrib>McCabe, Carolyn H</creatorcontrib><creatorcontrib>Cannon, Christopher P</creatorcontrib><creatorcontrib>Braunwald, Eugene</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American College of Cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Morrow, David A</au><au>Rifai, Nader</au><au>Antman, Elliott M</au><au>Weiner, Debra L</au><au>McCabe, Carolyn H</au><au>Cannon, Christopher P</au><au>Braunwald, Eugene</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Serum amyloid A predicts early mortality in acute coronary syndromes: a TIMI 11A substudy</atitle><jtitle>Journal of the American College of Cardiology</jtitle><addtitle>J Am Coll Cardiol</addtitle><date>2000-02-01</date><risdate>2000</risdate><volume>35</volume><issue>2</issue><spage>358</spage><epage>362</epage><pages>358-362</pages><issn>0735-1097</issn><eissn>1558-3597</eissn><coden>JACCDI</coden><abstract>OBJECTIVES
We evaluated the ability of serum amyloid A (SAA), alone and in combination with a rapid qualitative assay for cardiac-specific troponin T (cTnT), to predict 14-day mortality in patients with unstable angina or non-Q wave myocardial infarction (NQMI).
BACKGROUND
Elevated C-reactive protein (CRP) has been associated with adverse outcomes in unstable coronary syndromes but data regarding its acute phase counterpart, SAA, are conflicting.
METHODS
Serum amyloid A measurement and a rapid cTnT assay were performed on blood obtained at enrollment into Thrombolysis in Myocardial Infarction 11A, a dose-ranging trial of enoxaparin for unstable angina and NQMI.
RESULTS
Serum amyloid A was higher in patients who died compared with survivors (6.28 vs. 0.75 mg/dL, p = 0.002). Among patients with a negative rapid cTnT, mortality was higher for those in the top quintile of SAA (6.1 vs. 0.7%, p = 0.003). Patients with both an early positive rapid cTnT (≤10 min until assay positive) and SAA in the fifth quintile had the highest mortality followed by those with either markedly elevated SAA or an early positive rapid cTnT, while patients with both a negative rapid cTnT and SAA in quintiles 1–4 were at very low risk, (9.1 vs. 3.6 vs. 0.7%, p <0.002).
CONCLUSIONS
Similar to CRP, baseline elevation of SAA identifies patients hospitalized with unstable angina and NQMI at higher risk for early mortality, even among those with a negative rapid assay for cTnT. These data support further investigation of inflammatory markers used alone and in combination with cardiac troponins for risk assessment in unstable coronary syndromes.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>10676681</pmid><doi>10.1016/S0735-1097(99)00574-4</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; ScienceDirect Journals (5 years ago - present); Alma/SFX Local Collection |
| subjects | Angina, Unstable - blood Angina, Unstable - drug therapy Angina, Unstable - mortality Apolipoproteins - metabolism Biological and medical sciences Biomarkers - blood Cardiology. Vascular system Coronary heart disease Electrocardiography Female Fibrinolytic Agents - therapeutic use Heart Humans Male Medical sciences Middle Aged Prognosis Protein Precursors - blood Serum Amyloid A Protein - metabolism Survival Rate Thrombolytic Therapy |
| title | Serum amyloid A predicts early mortality in acute coronary syndromes: a TIMI 11A substudy |
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