Multiple biomarkers for the prediction of short and long-term mortality after ST-segment elevation myocardial infarction: the Amsterdam Groningen collaboration

P Damman, MA Kampinga, ICC van der Horst… - Journal of thrombosis …, 2013 - Springer
P Damman, MA Kampinga, ICC van der Horst, P Woudstra, MJ Grundeken, WJ Kuijt…
Journal of thrombosis and thrombolysis, 2013Springer
Multiple biomarkers improve prognostication for long-term mortality in ST-segment elevation
myocardial infarction (STEMI). However, one-third of mortality after STEMI occurs within
initial discharge. Our objective was to determine whether multiple biomarkers (glucose, N-
terminal pro-brain natriuretic peptide (NT-proBNP), and estimated glomerular filtration rate
(eGFR)) predict both short-term as long-term mortality in STEMI. We used a patient-pooled
dataset of consecutive STEMI patients, with complete biomarkers, who underwent primary …
Abstract
Multiple biomarkers improve prognostication for long-term mortality in ST-segment elevation myocardial infarction (STEMI). However, one-third of mortality after STEMI occurs within initial discharge. Our objective was to determine whether multiple biomarkers (glucose, N-terminal pro-brain natriuretic peptide (NT-proBNP), and estimated glomerular filtration rate (eGFR)) predict both short-term as long-term mortality in STEMI. We used a patient-pooled dataset of consecutive STEMI patients, with complete biomarkers, who underwent primary percutaneous coronary intervention (PCI) in two single centers (Amsterdam and Groningen). With a previously developed multimarker risk score, based on three biomarkers, patients were indicated as low-, intermediate- or high risk. Cumulative 4-year mortality was estimated with the Kaplan–Meier method and compared with a log-rank test. We compared short-term and long-term mortality with a landmark set at 30 days because previous studies have shown that mortality largely occurs within 30 days. A total of 2,355 STEMI-patients were treated with primary PCI. The mortality rates in the low- (n = 1,531), intermediate- (n = 403) and high-risk (n = 421) groups were 4.8, 16.1, and 43.9 %, respectively. The differences were observed at a follow-up up to 30 days (log-rank p < 0.001) as well as after 30 days (log-rank p < 0.001). A multimarker risk score, based on admission levels of glucose, NT-proBNP, and eGFR identifies STEMI patients at low-, intermediate-, and high-risk for short-term and long-term mortality.
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