Prognostic Value of Cardiac Troponin T and Sex in Patients Undergoing Elective Percutaneous Coronary Intervention
Background In patients with stable coronary artery disease undergoing elective percutaneous coronary intervention, the prognostic value of high‐sensitivity cardiac troponin T (hs‐cTnT) and the influence of sex remain poorly defined. Methods and Results Consecutive patients with stable coronary arter...
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| Format: | Article |
| Language: | English |
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Wiley
2016-12-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.116.004464 |
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| author | Yukinori Harada Jonathan Michel Wolfgang Koenig Tobias Rheude Roisin Colleran Daniele Giacoppo Adnan Kastrati Robert A. Byrne |
| author_facet | Yukinori Harada Jonathan Michel Wolfgang Koenig Tobias Rheude Roisin Colleran Daniele Giacoppo Adnan Kastrati Robert A. Byrne |
| author_sort | Yukinori Harada |
| collection | DOAJ |
| description | Background In patients with stable coronary artery disease undergoing elective percutaneous coronary intervention, the prognostic value of high‐sensitivity cardiac troponin T (hs‐cTnT) and the influence of sex remain poorly defined. Methods and Results Consecutive patients with stable coronary artery disease who underwent elective percutaneous coronary intervention were included. Primary endpoint was all‐cause mortality. Unadjusted hazard ratio (HR) in overall and sex‐specific population and multivariable adjusted HR were calculated by using Cox proportional hazard models. In a total of 5626 patients, elevated hs‐cTnT levels, more than the sex‐specific 99th percentile upper reference limit of normal (URL), were observed in 2221 patients (39%) at baseline. During follow‐up (median, 14.5 months; 25th–75th percentiles, 6.4–27.2 months), 265 patients died. Mortality was higher in patients with the sex‐specific 99th percentile URL compared to those with normal hs‐cTnT (17.3% vs 3.4%; HR=6.10; 95% CI, 4.58–8.14; P<0.001). hs‐cTnT was an independent predictor of mortality in multivariable adjusted models. The C‐statistic was significantly increased by adding hs‐cTnT to the basic prediction model for mortality (0.793–0.815; P<0.001). There was a significant interaction between hs‐cTnT and sex on mortality. Differences in all‐cause mortality between patients with more than the sex‐specific 99th percentile URL and those with normal hs‐cTnT were numerically larger in male than female patients (male, HR=6.45; 95% CI, 4.68–8.87, P<0.001; female, HR=4.29, 95% CI, 2.36–9.03; P<0.001). Conclusions In patients with stable coronary artery disease undergoing elective percutaneous coronary intervention, preprocedural hs‐cTnT was a strong predictor of mortality in both men and women. |
| format | Article |
| id | doaj-art-912a7802b52043e385475191abc3c251 |
| institution | Kabale University |
| issn | 2047-9980 |
| language | English |
| publishDate | 2016-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-912a7802b52043e385475191abc3c2512025-08-20T03:29:09ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802016-12-0151210.1161/JAHA.116.004464Prognostic Value of Cardiac Troponin T and Sex in Patients Undergoing Elective Percutaneous Coronary InterventionYukinori Harada0Jonathan Michel1Wolfgang Koenig2Tobias Rheude3Roisin Colleran4Daniele Giacoppo5Adnan Kastrati6Robert A. Byrne7Deutsches Herzzentrum München Technische Universität München Munich GermanyDeutsches Herzzentrum München Technische Universität München Munich GermanyDeutsches Herzzentrum München Technische Universität München Munich GermanyDeutsches Herzzentrum München Technische Universität München Munich GermanyDeutsches Herzzentrum München Technische Universität München Munich GermanyDeutsches Herzzentrum München Technische Universität München Munich GermanyDeutsches Herzzentrum München Technische Universität München Munich GermanyDeutsches Herzzentrum München Technische Universität München Munich GermanyBackground In patients with stable coronary artery disease undergoing elective percutaneous coronary intervention, the prognostic value of high‐sensitivity cardiac troponin T (hs‐cTnT) and the influence of sex remain poorly defined. Methods and Results Consecutive patients with stable coronary artery disease who underwent elective percutaneous coronary intervention were included. Primary endpoint was all‐cause mortality. Unadjusted hazard ratio (HR) in overall and sex‐specific population and multivariable adjusted HR were calculated by using Cox proportional hazard models. In a total of 5626 patients, elevated hs‐cTnT levels, more than the sex‐specific 99th percentile upper reference limit of normal (URL), were observed in 2221 patients (39%) at baseline. During follow‐up (median, 14.5 months; 25th–75th percentiles, 6.4–27.2 months), 265 patients died. Mortality was higher in patients with the sex‐specific 99th percentile URL compared to those with normal hs‐cTnT (17.3% vs 3.4%; HR=6.10; 95% CI, 4.58–8.14; P<0.001). hs‐cTnT was an independent predictor of mortality in multivariable adjusted models. The C‐statistic was significantly increased by adding hs‐cTnT to the basic prediction model for mortality (0.793–0.815; P<0.001). There was a significant interaction between hs‐cTnT and sex on mortality. Differences in all‐cause mortality between patients with more than the sex‐specific 99th percentile URL and those with normal hs‐cTnT were numerically larger in male than female patients (male, HR=6.45; 95% CI, 4.68–8.87, P<0.001; female, HR=4.29, 95% CI, 2.36–9.03; P<0.001). Conclusions In patients with stable coronary artery disease undergoing elective percutaneous coronary intervention, preprocedural hs‐cTnT was a strong predictor of mortality in both men and women.https://www.ahajournals.org/doi/10.1161/JAHA.116.004464percutaneous coronary interventionsexstable coronary artery diseasetroponin T |
| spellingShingle | Yukinori Harada Jonathan Michel Wolfgang Koenig Tobias Rheude Roisin Colleran Daniele Giacoppo Adnan Kastrati Robert A. Byrne Prognostic Value of Cardiac Troponin T and Sex in Patients Undergoing Elective Percutaneous Coronary Intervention Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease percutaneous coronary intervention sex stable coronary artery disease troponin T |
| title | Prognostic Value of Cardiac Troponin T and Sex in Patients Undergoing Elective Percutaneous Coronary Intervention |
| title_full | Prognostic Value of Cardiac Troponin T and Sex in Patients Undergoing Elective Percutaneous Coronary Intervention |
| title_fullStr | Prognostic Value of Cardiac Troponin T and Sex in Patients Undergoing Elective Percutaneous Coronary Intervention |
| title_full_unstemmed | Prognostic Value of Cardiac Troponin T and Sex in Patients Undergoing Elective Percutaneous Coronary Intervention |
| title_short | Prognostic Value of Cardiac Troponin T and Sex in Patients Undergoing Elective Percutaneous Coronary Intervention |
| title_sort | prognostic value of cardiac troponin t and sex in patients undergoing elective percutaneous coronary intervention |
| topic | percutaneous coronary intervention sex stable coronary artery disease troponin T |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.116.004464 |
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