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常规可用生物标志物作为完全血运重建的急性ST段抬高型心肌梗死患者发生收缩功能障碍的长期预测指标

ROUTINELY AVAILABLE BIOMARKERS AS LONG-TERM PREDICTORS OF DEVELOPING SYSTOLIC DYSFUNCTION IN COMPLETELY REVASCULARIZED PATIENTS WITH ACUTE ST ELEVATION MYOCARDIAL INFARCTION.

作者信息

Zeljković Ivan, Manola Šime, Radeljić Vjekoslav, Delić Brkljačić Diana, Babacanli Alen, Pavlović Nikola

机构信息

1Department of Cardiology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2Department of Emergency Medicine, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia.

出版信息

Acta Clin Croat. 2019 Mar;58(1):95-102. doi: 10.20471/acc.2019.58.01.12.

Abstract

The aim of this study was to assess the efficacy of high-sensitivity C-reactive protein (hsCRP), cardiac troponin T (cTnT) and creatine kinase (CK) as long-term predictors of reduced systolic function in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) with complete revascularization. This prospective study evaluated consecutive patients with acute STEMI who had normal left ventricular ejection fraction (LVEF ≥50%) at admission with single-vessel disease and underwent complete revascularization. Blood samples were collected from admission to day 7. The primary endpoint was reduction of LVEF <50% after 12 months. The study included 47 patients, median age 59±10 years, 74.5% of them men. Patients who developed systolic dysfunction (LVEF <50%) had significantly higher mean values of cTnT after 24 hours (5.11 . 2.82 µg/L, p=0.010) and peak values of CK (3375.5 . 1865 U/L, p=0.008). There was no significant relation between hsCRP and development of reduced LVEF (p=0.541). In conclusion, cTnT and CK could serve as long-term predictors of reduced left ventricular systolic function (<50%) in acute STEMI patients with normal systolic function at admission, single-vessel coronary disease and complete revascularization during primary PCI.

摘要

本研究旨在评估高敏C反应蛋白(hsCRP)、心肌肌钙蛋白T(cTnT)和肌酸激酶(CK)作为急性ST段抬高型心肌梗死(STEMI)患者接受直接经皮冠状动脉介入治疗(PCI)并实现完全血运重建后左心室收缩功能降低的长期预测指标的有效性。这项前瞻性研究评估了连续的急性STEMI患者,这些患者入院时左心室射血分数正常(LVEF≥50%),单支血管病变,并接受了完全血运重建。从入院到第7天采集血样。主要终点是12个月后LVEF降低至<50%。该研究纳入了47例患者,中位年龄59±10岁,其中74.5%为男性。发生收缩功能障碍(LVEF<50%)的患者在24小时后的cTnT平均值(5.11. 2.82μg/L,p=0.010)和CK峰值(3375.5. 1865 U/L,p=0.008)显著更高。hsCRP与LVEF降低的发生之间无显著相关性(p=0.541)。总之,cTnT和CK可作为入院时收缩功能正常、单支冠状动脉病变且在直接PCI期间实现完全血运重建的急性STEMI患者左心室收缩功能降低(<50%)的长期预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cdde/6629206/e1bf7db8d235/acc-58-95-f1.jpg

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