Prognostic relevance of cardiac troponin T levels and their dynamic changes measured with a high-sensitivity assay in acute ischaemic stroke: Analyses from the TRELAS cohort

医学 内科学 危险系数 置信区间 肌钙蛋白复合物 心脏病学 优势比 改良兰金量表 人口 比例危险模型 冲程(发动机) 肌钙蛋白T 前瞻性队列研究 肌钙蛋白 心肌梗塞 缺血 缺血性中风 工程类 环境卫生 机械工程
作者
Jan F. Scheitz,Hans-C. Mochmann,Hebun Erdur,Serdar Tütüncü,Karl Georg Hæusler,Ulrike Grittner,Ulrich Laufs,Matthias Endres,Christian H. Nolte
出处
期刊:International Journal of Cardiology [Elsevier BV]
卷期号:177 (3): 886-893 被引量:90
标识
DOI:10.1016/j.ijcard.2014.10.036
摘要

To assess the prognostic relevance of cardiac troponin T (cTnT) values and their serial changes as measured with a high-sensitivity assay in acute ischaemic stroke.In total, 1016 consecutive acute ischaemic stroke patients were registered prospectively within a two-year period. High-sensitivity cTnT was quantitated on admission and the following day. Patients were stratified into three groups: below the 99 th percentile of a healthy reference population (< 14 ng/l; n = 409), moderately elevated cTnT (below the median of remaining patients, 14-30 ng/l; n=299) and high cTnT (> 30 ng/l; n = 308). Outcome measures were unfavourable outcome (modified Rankin Scale ≥ 2 at hospital discharge, n=604) and in-hospital mortality (n = 36). Peak cTnT levels were significantly associated with unfavourable outcome (adjusted odds ratios versus reference for moderately elevated cTnT 1.7, 95% confidence interval [CI] 1.1-2.7 and for high cTnT 3.1, 95% CI 1.8-5.6). The optimal cut-off for determining unfavourable outcome proved to be 16 ng/l. Adding this cut-off to clinical variables led to a significant improvement of c-statistics (0.851 versus 0.838, p=0.02). Dynamic changes (δ ≥ 50%) of cTnT were detected in 137 patients (13%). Multiple Cox regression analysis showed an independent association of dynamic changes in cTnT with in-hospital mortality (hazard ratio 2.3, 95% CI 1.1-4.7). The model-fitting (p<0.001) and c-statistics (0.889 versus 0.863, p = 0.08) improved most after dynamic change in cTnT had been added to a regression model which included clinical variables alone.Our study adds novel findings relevant for interpretation of highly sensitive cTnT assays in acute ischaemic stroke: a) Myocardial injury is detectable in more than half of patients; b) even moderately elevated cTnT is associated with unfavourable outcome (optimal cut-off 16 ng/l); and c) dynamic changes in cTnT indicate an increased risk of in-hospital death.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
刚刚
1秒前
1秒前
lm发布了新的文献求助10
2秒前
2秒前
2秒前
zhao完成签到,获得积分10
2秒前
weiwei完成签到,获得积分10
2秒前
科研通AI2S应助姜凯采纳,获得10
3秒前
孙福禄应助西西采纳,获得10
4秒前
孙福禄应助西西采纳,获得10
4秒前
4秒前
单纯青槐发布了新的文献求助10
4秒前
4秒前
4秒前
luckbaby完成签到,获得积分10
5秒前
方赫然发布了新的文献求助10
5秒前
JerryZ发布了新的文献求助10
5秒前
今后应助高贵绿真采纳,获得10
5秒前
Ava应助mariawang采纳,获得10
5秒前
5秒前
菜不透发布了新的文献求助10
6秒前
6秒前
纸猫发布了新的文献求助10
6秒前
7秒前
weiwei发布了新的文献求助10
7秒前
poli发布了新的文献求助10
8秒前
诚心尔琴发布了新的文献求助10
9秒前
9秒前
fgh完成签到,获得积分20
9秒前
CipherSage应助科研通管家采纳,获得10
10秒前
CAOHOU应助科研通管家采纳,获得10
10秒前
NexusExplorer应助科研通管家采纳,获得10
10秒前
SYLH应助科研通管家采纳,获得10
10秒前
英俊的铭应助科研通管家采纳,获得10
10秒前
Akim应助科研通管家采纳,获得10
10秒前
SYLH应助科研通管家采纳,获得10
10秒前
10秒前
CodeCraft应助科研通管家采纳,获得10
11秒前
乐乐应助科研通管家采纳,获得10
11秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
‘Unruly’ Children: Historical Fieldnotes and Learning Morality in a Taiwan Village (New Departures in Anthropology) 400
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
基于可调谐半导体激光吸收光谱技术泄漏气体检测系统的研究 350
Robot-supported joining of reinforcement textiles with one-sided sewing heads 320
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3988786
求助须知:如何正确求助?哪些是违规求助? 3531116
关于积分的说明 11252493
捐赠科研通 3269766
什么是DOI,文献DOI怎么找? 1804771
邀请新用户注册赠送积分活动 881870
科研通“疑难数据库(出版商)”最低求助积分说明 809021