التفاصيل البيبلوغرافية
| العنوان: |
The significance of circulating levels of both cardiac troponin I and high-sensitivity C reactive protein for the prediction of intravenous thrombolysis outcome in patients with ST-segment elevation myocardial infarction. |
| المؤلفون: |
Foussas, S. G., Zairis, M. N., Makrygiannis, S. S., Manousakis, S. J., Anastassiadis, F. A., Apostolatos, C. S., Patsourakos, N. G., Glyptis, M. P., Papadopoulos, J. K., Xenos, D. C., Adamopoulou, E. N., Olympios, C. D., Argyrakis, S. K. |
| المصدر: |
Heart; Aug2007, Vol. 93 Issue 8, p952-956, 5p, 4 Charts, 1 Graph |
| مصطلحات موضوعية: |
CORONARY disease, MYOCARDIAL infarction treatment, CARDIOVASCULAR disease treatment, THROMBOLYTIC therapy, C-reactive protein |
| مستخلص: |
Objectives: To evaluate, using continuous 12-lead ECG ST-segment monitoring, the role of circulating levels of both cardiac troponin I (cTnl) and high-sensitivity C reactive protein (hs-CRP), on presentation, in the prediction of intravenous thrombolysis outcome in patients with ST-segment elevation myocardial infarction (STEMI). Design and setting: Prospective observational study in a tertiary referral centre. Patients: 786 consecutive patients with STEMI, who received intravenous thrombolysis in the first 6 h from index pain. Main outcome measures: The incidence of failed thrombolysis and of cardiac death by 30 days. Failed thrombolysis was defined as the absence of abrupt and sustained ⩾50% ST-segment recovery in the first 90 mm after the initiation of intravenous thrombolysis. Results: The incidence of failed thrombolysis and 30-day cardiac death was 57.4% and 11.8%, respectively. By multivariate logistic regression analysis according to tertiles of both cTnl (RR, 1.5; 95% CI 1.1 to 1.8, p = 0.004 for highest vs middle third; 2.2, 1.9 to 3.5, p<0.001 for highest vs lowest third; 1.5, 1.2 to 1.8, p = 0.001 for middle vs lowest third) and hs-CRP (RR, 2.0, 95% CI, 1.6 to 2.2; p<0.001 for highest vs middle third; 2.6, 2.1 to 3.5, p<0.001 for highest vs lowest third; 1.3, 1.2 to 1.7, p=0.02 for middle vs lowest third), were independently associated with failed thrombolysis. Moreover, by multivariate Cox regression analysis according to tertiles of both cTnl (HR 1.2, 95% CI 1.1 to 1.8, p = 0.03 for highest vs middle third; 1.5, 1.2 to 2.2, p = 0.004 for highest vs lowest third; 1.1, 0.6 to 1.4, p = 0.6 for middle vs lowest third) and hs-CRP (HR 1.2, 95% CI 1.1 to 1.6, p = 0.04 for highest vs middle third; 1.7, 1.3 to 2.6, p = 0.001 for highest vs lowest third; 1.1, 0.9 to 2.1, p = 0.1 for middle vs lowest third), were independently related with an increased risk of 30-day cardiac death. Conclusions: High circulating levels of both cTnl and hs-CRP are related with an independent increased risk of intravenous thrombolysis failure and 30-day cardiac death in patients who received intravenous thrombolysis in the first 6 h of STEMI. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
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