[HTML][HTML] Multimarker approach for the prediction of microvascular obstruction after acute ST-segment elevation myocardial infarction: a prospective, observational …

HJ Feistritzer, SJ Reinstadler… - BMC …, 2016 - bmccardiovascdisord.biomedcentral …
HJ Feistritzer, SJ Reinstadler, G Klug, M Reindl, S Wöhrer, C Brenner, A Mayr, J Mair…
BMC cardiovascular disorders, 2016bmccardiovascdisord.biomedcentral …
Presence of microvascular obstruction (MVO) derived from cardiac magnetic resonance
(CMR) imaging is among the strongest outcome predictors after ST-segment elevation
myocardial infarction (STEMI). We aimed to investigate the comparative predictive values of
different biomarkers for the occurrence of MVO in a large cohort of reperfused STEMI
patients. This study included 128 STEMI patients. CMR imaging was performed within the
first week after infarction to assess infarct characteristics, including MVO. Admission and …
Presence of microvascular obstruction (MVO) derived from cardiac magnetic resonance (CMR) imaging is among the strongest outcome predictors after ST-segment elevation myocardial infarction (STEMI). We aimed to investigate the comparative predictive values of different biomarkers for the occurrence of MVO in a large cohort of reperfused STEMI patients. This study included 128 STEMI patients. CMR imaging was performed within the first week after infarction to assess infarct characteristics, including MVO. Admission and peak concentrations of high-sensitivity cardiac troponin T (hs-cTnT), creatine kinase (CK), N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hs-CRP), lactate dehydrogenase (LDH), aspartate transaminase (AST) and alanine transaminase (ALT) were measured. MVO was detected in 69 patients (54%). hs-cTnT, CK, hs-CRP, LDH, AST and ALT peak concentrations showed similar prognostic value for the prediction of MVO (area under the curve (AUC) = 0.77, 0.77, 0.68, 0.79, 0.78 and 0.73, all p > 0.05), whereas the prognostic utility of NT-proBNP was weakly lower (AUC = 0.64, p < 0.05). Combination of these biomarkers did not increase predictive utility compared to hs-cTnT alone (p = 0.349). hs-cTnT, CK, hs-CRP, LDH, AST and ALT peak concentrations provided similar prognostic value for the prediction of MVO. The prognostic utility of NT-proBNP was lower. Combining these biomarkers could not further improve predictive utility compared to hs-cTnT alone.
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