Troponin T concentration 3 days after acute ST-elevation myocardial infarction predicts infarct size and cardiac function at 3 months

Cardiology. 2009;113(3):207-12. doi: 10.1159/000201991. Epub 2009 Feb 14.

Abstract

Objectives: The evaluation of infarct size and left ventricular function after acute myocardial infarction is important for predicting the subsequent clinical course. This assessment can be achieved by non-invasive imaging methods, but biochemical assays are frequently used as an alternative. We investigated the ability of a single measurement of cardiac troponin T (cTnT) the third morning after onset of ST-segment elevation myocardial infarction (STEMI) to predict infarct size and left ventricular ejection fraction (LVEF).

Methods: The study population consisted of 103 patients with their first STEMI treated with thrombolysis. Blood samples for determination of cTnT were drawn the third morning after onset of symptoms. Infarct size and LVEF were assessed by magnetic resonance imaging 3 months later.

Results: Linear regression analysis showed a strong, significant correlation between third-day cTnT and infarct size at 3 months (r = 0.84, p < 0.0001). A significant but inverse and weaker correlation was obtained between third-day cTnT and LVEF (r = -0.63, p < 0.0001). Adjusting for age, gender, infarct location and medication changed the results marginally.

Conclusions: A single cTnT value the third morning after onset of STEMI predicted the final infarct size in this group of patients with their first STEMI, and might be useful for ruling out impaired LVEF.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biomarkers / blood*
  • Electrocardiography
  • Female
  • Follow-Up Studies
  • Humans
  • Linear Models
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Myocardial Infarction* / blood
  • Myocardial Infarction* / diagnosis
  • Myocardial Infarction* / therapy
  • Predictive Value of Tests
  • ROC Curve
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Stroke Volume
  • Thrombolytic Therapy*
  • Treatment Outcome
  • Troponin T / blood*

Substances

  • Biomarkers
  • Troponin T