Relation of troponin T release kinetics to long-term clinical outcome in patients with acute ST segment elevation myocardial infarction treated with a percutaneous intervention

The purpose of this study was to determine the relation of troponin T release kinetics to long‐term clinical outcome in patients with an acute ST segment elevation myocardial infarction treated with a primary percutaneous intervention. One hundred and four patients with typical ischemic chest pain and > 1.5 mm ST segment elevation in > 2 contiguous leads underwent primary stenting (n = 60) or primary percutaneous transluminal coronary angioplasty (n = 44). Serum troponin T concentrations were obtained prior to and serially postintervention for 72 hr. Mean time to peak serum troponin T concentration was significantly longer in patients with cardiac death (P = 0.02), reinfarction (P = 0.007), target lesion reintervention (P = 0.03), and the composite of these events (13.2 ± 5.3 vs. 9.3 ± 4.0 hr; P < 0.0005). Multivariate analysis identified age, Killip class > 2, and time to peak serum troponin T concentration as independent predictors of long‐term cardiac event‐free survival. Thus, time to peak serum troponin T concentration independently predicts long‐term cardiac event‐free survival in patients with acute ST segment elevation myocardial infarction treated with a primary percutaneous intervention. Cathet Cardiovasc Intervent 2002;56:312–319. © 2002 Wiley‐Liss, Inc.