Minor elevations in troponin I are associated with mortality and adverse cardiac events in patients with atrial fibrillation
In patients with atrial fibrillation, minor troponin I elevation is regularly detected; however, the prognostic significance of this finding is unknown. We therefore sought to examine the prognostic value of elevated troponin I in patients with atrial fibrillation. A prospective study was conducted...
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| Veröffentlicht in: | European heart journal 2011-03, Vol.32 (5), p.611-617 |
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| container_title | European heart journal |
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| creator | VAN DEN BOS, Ewout J CONSTANTINESCU, Alina A VAN DOMBURG, Ron T AKIN, Sakir JORDAENS, Luc J KOFFLARD, Marcel J. M |
| description | In patients with atrial fibrillation, minor troponin I elevation is regularly detected; however, the prognostic significance of this finding is unknown. We therefore sought to examine the prognostic value of elevated troponin I in patients with atrial fibrillation.
A prospective study was conducted analysing all consecutive patients admitted with atrial fibrillation in a 2-year period. Patients with an ST-elevation myocardial infarction (MI) were excluded. Minor troponin elevation was defined as a troponin I level between 0.15 and 0.65 ng/mL, which is still below the 99th percentile of the upper reference limit. A positive troponin I was defined as ≥ 0.65 ng/mL. Study outcomes were all-cause mortality (death), death and myocardial infarction (death/MI), or all major adverse cardiac events (MACE: death, MI, or revascularization). A total of 407 patients were eligible for inclusion. The median duration of follow-up was 688 days. A minor elevation occurred in 81 (20%) patients and 77 (19%) had a positive troponin I. In a multivariate model, minor troponin I elevation and a positive troponin I were independently associated with death [hazard ratio (HR): 2.36, 95% confidence interval (CI): 1.17-4.73 for minor elevation and HR: 3.77, 95% CI: 1.42-10.02 for positive troponin I]. Also, there was an independent correlation between the combined endpoints of death/MI and MACE and both a minor elevation and a positive troponin I.
Minor elevations in troponin I on hospital admission are associated with mortality and cardiac events in patients with atrial fibrillation and might be useful for risk stratification. |
| doi_str_mv | 10.1093/eurheartj/ehq491 |
| format | Article |
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A prospective study was conducted analysing all consecutive patients admitted with atrial fibrillation in a 2-year period. Patients with an ST-elevation myocardial infarction (MI) were excluded. Minor troponin elevation was defined as a troponin I level between 0.15 and 0.65 ng/mL, which is still below the 99th percentile of the upper reference limit. A positive troponin I was defined as ≥ 0.65 ng/mL. Study outcomes were all-cause mortality (death), death and myocardial infarction (death/MI), or all major adverse cardiac events (MACE: death, MI, or revascularization). A total of 407 patients were eligible for inclusion. The median duration of follow-up was 688 days. A minor elevation occurred in 81 (20%) patients and 77 (19%) had a positive troponin I. In a multivariate model, minor troponin I elevation and a positive troponin I were independently associated with death [hazard ratio (HR): 2.36, 95% confidence interval (CI): 1.17-4.73 for minor elevation and HR: 3.77, 95% CI: 1.42-10.02 for positive troponin I]. Also, there was an independent correlation between the combined endpoints of death/MI and MACE and both a minor elevation and a positive troponin I.
Minor elevations in troponin I on hospital admission are associated with mortality and cardiac events in patients with atrial fibrillation and might be useful for risk stratification.</description><identifier>ISSN: 0195-668X</identifier><identifier>EISSN: 1522-9645</identifier><identifier>DOI: 10.1093/eurheartj/ehq491</identifier><identifier>PMID: 21252170</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Aged ; Aged, 80 and over ; Analysis of Variance ; Atrial Fibrillation - metabolism ; Atrial Fibrillation - mortality ; Biological and medical sciences ; Biomarkers - metabolism ; Cardiac dysrhythmias ; Cardiology. Vascular system ; Cause of Death ; Female ; Heart ; Humans ; Kaplan-Meier Estimate ; Male ; Medical sciences ; Middle Aged ; Myocardial Infarction - mortality ; Myocardial Ischemia - mortality ; Myocardial Revascularization - mortality ; Prognosis ; Prospective Studies ; Risk Assessment ; Troponin I - metabolism</subject><ispartof>European heart journal, 2011-03, Vol.32 (5), p.611-617</ispartof><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c370t-e8a2c11181e6e2caefebb44046224d959f587ac4e51e5b15c01eb4379116b3be3</citedby><cites>FETCH-LOGICAL-c370t-e8a2c11181e6e2caefebb44046224d959f587ac4e51e5b15c01eb4379116b3be3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,782,786,27931,27932</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23897406$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21252170$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>VAN DEN BOS, Ewout J</creatorcontrib><creatorcontrib>CONSTANTINESCU, Alina A</creatorcontrib><creatorcontrib>VAN DOMBURG, Ron T</creatorcontrib><creatorcontrib>AKIN, Sakir</creatorcontrib><creatorcontrib>JORDAENS, Luc J</creatorcontrib><creatorcontrib>KOFFLARD, Marcel J. M</creatorcontrib><title>Minor elevations in troponin I are associated with mortality and adverse cardiac events in patients with atrial fibrillation</title><title>European heart journal</title><addtitle>Eur Heart J</addtitle><description>In patients with atrial fibrillation, minor troponin I elevation is regularly detected; however, the prognostic significance of this finding is unknown. We therefore sought to examine the prognostic value of elevated troponin I in patients with atrial fibrillation.
A prospective study was conducted analysing all consecutive patients admitted with atrial fibrillation in a 2-year period. Patients with an ST-elevation myocardial infarction (MI) were excluded. Minor troponin elevation was defined as a troponin I level between 0.15 and 0.65 ng/mL, which is still below the 99th percentile of the upper reference limit. A positive troponin I was defined as ≥ 0.65 ng/mL. Study outcomes were all-cause mortality (death), death and myocardial infarction (death/MI), or all major adverse cardiac events (MACE: death, MI, or revascularization). A total of 407 patients were eligible for inclusion. The median duration of follow-up was 688 days. A minor elevation occurred in 81 (20%) patients and 77 (19%) had a positive troponin I. In a multivariate model, minor troponin I elevation and a positive troponin I were independently associated with death [hazard ratio (HR): 2.36, 95% confidence interval (CI): 1.17-4.73 for minor elevation and HR: 3.77, 95% CI: 1.42-10.02 for positive troponin I]. Also, there was an independent correlation between the combined endpoints of death/MI and MACE and both a minor elevation and a positive troponin I.
Minor elevations in troponin I on hospital admission are associated with mortality and cardiac events in patients with atrial fibrillation and might be useful for risk stratification.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Analysis of Variance</subject><subject>Atrial Fibrillation - metabolism</subject><subject>Atrial Fibrillation - mortality</subject><subject>Biological and medical sciences</subject><subject>Biomarkers - metabolism</subject><subject>Cardiac dysrhythmias</subject><subject>Cardiology. Vascular system</subject><subject>Cause of Death</subject><subject>Female</subject><subject>Heart</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myocardial Infarction - mortality</subject><subject>Myocardial Ischemia - mortality</subject><subject>Myocardial Revascularization - mortality</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Risk Assessment</subject><subject>Troponin I - metabolism</subject><issn>0195-668X</issn><issn>1522-9645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkDFv2zAQRomiQeOm3TsVXIpMSngUSYljYTRtAAdZEqCbcKJOMANZtEnaRYD8-Ci260x3w_u-OzzGvoG4AmHLa9rGJWHMT9e03CgLH9gMtJSFNUp_ZDMBVhfG1H_P2eeUnoQQtQHziZ1LkFpCJWbs5c6PIXIaaIfZhzFxP_IcwzqM03LLMRLHlILzmKnj_3xe8lWIGQefnzmOHcduRzERdxg7j47Tjsa8r1lPjft9n8IcPQ689230w7A_9oWd9Tgk-nqcF-zx5tfD_E-xuP99O_-5KFxZiVxQjdIBQA1kSDqkntpWKaGMlKqz2va6rtAp0kC6Be0EUKvKygKYtmypvGCXh951DJstpdysfHI0fTFS2Kam1loKY0s9keJAuhhSitQ36-hXGJ8bEM2b8uakvDkonyLfj-XbdkXdKfDf8QT8OAKYHA59xNH59M6Vta2UMOUrptCQIg</recordid><startdate>20110301</startdate><enddate>20110301</enddate><creator>VAN DEN BOS, Ewout J</creator><creator>CONSTANTINESCU, Alina A</creator><creator>VAN DOMBURG, Ron T</creator><creator>AKIN, Sakir</creator><creator>JORDAENS, Luc J</creator><creator>KOFFLARD, Marcel J. 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Vascular system</topic><topic>Cause of Death</topic><topic>Female</topic><topic>Heart</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Myocardial Infarction - mortality</topic><topic>Myocardial Ischemia - mortality</topic><topic>Myocardial Revascularization - mortality</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Risk Assessment</topic><topic>Troponin I - metabolism</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>VAN DEN BOS, Ewout J</creatorcontrib><creatorcontrib>CONSTANTINESCU, Alina A</creatorcontrib><creatorcontrib>VAN DOMBURG, Ron T</creatorcontrib><creatorcontrib>AKIN, Sakir</creatorcontrib><creatorcontrib>JORDAENS, Luc J</creatorcontrib><creatorcontrib>KOFFLARD, Marcel J. 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M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Minor elevations in troponin I are associated with mortality and adverse cardiac events in patients with atrial fibrillation</atitle><jtitle>European heart journal</jtitle><addtitle>Eur Heart J</addtitle><date>2011-03-01</date><risdate>2011</risdate><volume>32</volume><issue>5</issue><spage>611</spage><epage>617</epage><pages>611-617</pages><issn>0195-668X</issn><eissn>1522-9645</eissn><abstract>In patients with atrial fibrillation, minor troponin I elevation is regularly detected; however, the prognostic significance of this finding is unknown. We therefore sought to examine the prognostic value of elevated troponin I in patients with atrial fibrillation.
A prospective study was conducted analysing all consecutive patients admitted with atrial fibrillation in a 2-year period. Patients with an ST-elevation myocardial infarction (MI) were excluded. Minor troponin elevation was defined as a troponin I level between 0.15 and 0.65 ng/mL, which is still below the 99th percentile of the upper reference limit. A positive troponin I was defined as ≥ 0.65 ng/mL. Study outcomes were all-cause mortality (death), death and myocardial infarction (death/MI), or all major adverse cardiac events (MACE: death, MI, or revascularization). A total of 407 patients were eligible for inclusion. The median duration of follow-up was 688 days. A minor elevation occurred in 81 (20%) patients and 77 (19%) had a positive troponin I. In a multivariate model, minor troponin I elevation and a positive troponin I were independently associated with death [hazard ratio (HR): 2.36, 95% confidence interval (CI): 1.17-4.73 for minor elevation and HR: 3.77, 95% CI: 1.42-10.02 for positive troponin I]. Also, there was an independent correlation between the combined endpoints of death/MI and MACE and both a minor elevation and a positive troponin I.
Minor elevations in troponin I on hospital admission are associated with mortality and cardiac events in patients with atrial fibrillation and might be useful for risk stratification.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>21252170</pmid><doi>10.1093/eurheartj/ehq491</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Aged, 80 and over Analysis of Variance Atrial Fibrillation - metabolism Atrial Fibrillation - mortality Biological and medical sciences Biomarkers - metabolism Cardiac dysrhythmias Cardiology. Vascular system Cause of Death Female Heart Humans Kaplan-Meier Estimate Male Medical sciences Middle Aged Myocardial Infarction - mortality Myocardial Ischemia - mortality Myocardial Revascularization - mortality Prognosis Prospective Studies Risk Assessment Troponin I - metabolism |
| title | Minor elevations in troponin I are associated with mortality and adverse cardiac events in patients with atrial fibrillation |
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