Resumen
Objective: To examine the association of cTnI elevation and risk of serious cardiac complications and in-hospital death in Hispanics with an AMI residing in Puerto Rico. Material and methods: Patients from the Puerto Rico Heart Attack Study hospitalized during 2007, 2009, and 2011 with a validated AMI diagnosis and with cTnI obtained within the first 24-hours of admission were included for analysis. cTnI increase >10µg/L was defined as high. We utilized logistic regression modeling to examine the association of cTnI levels and serious cardiac complications (atrial/ventricular tachycardia/fibrillation, atrioventricular block, papillary muscle rupture, heart failure and cardiogenic shock) and death while controlling for potential confounders. Results: Approximately 52% (1,542) patients met the inclusion criteria. The overall mean age was 66 ± 14 years and 848 (55%) were men. After adjusting for age, gender and comorbidities, patients with high cTnI levels had almost five-times the odds of developing serious cardiac complications (OR=4.8, 95%CI=3.2-7.0; p<0.001) and twice the odds of dying (OR=2.1, 95%CI=1.3-3.3; p=0.002) than those with lower cTnI levels. Conclusion: Puerto Ricans with AMI and cTnI levels >10µg/L at admission had significantly higher odds of serious cardiac complications and death than those with lower cTnI levels.Descargas
Los datos de descargas todavía no están disponibles.
Citas
- Mozaffarian D, Benjamin EJ, Go AS, et al. Heart disease and stroke statistics— 2015 update: a report from the American Heart Association. Circulation. 2015 Jan 27;131(4):e29-322.
- Zevallos J, Yarzebzki J, et al. Gender disparities in Puerto Ricans hospitalized with an initial acute myocardial infarction: a population-based perspective. P R Health Sci J. 2012 Dec;31(4):192-8.
- Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD; the Writing Group on behalf of the Joint ESC/ACCF/AHA/WHF Task Force for the Universal Definition of Myocardial Infarction. Third universal definition of myocardial infarction. Circulation. 2012;126:2020–2035.
- Antman EM, Tanasijevic MJ, Thompson B, et al. Cardiac-specific troponin I levels to predict the risk of mortality in patients with acute coronary syndromes. N Engl J Med.1996;335:1342–1349.
- Ottani, F, Galvani, M, Nicolini, FA, et al. Elevated cardiac troponin levels predict the risk of adverse outcome in patients with acute coronary syndromes. Am Heart J 2000; 140:917
- Cavallini C, Savonitto S. Prognostic Value of Isolated Troponin I Elevation After Percutaneous Coronary Intervention. Ital Heart J Suppl. 2002 Mar;3(3):286-96.
- United States Census Bureau. Available at: https://www.census.gov/prod/cen2010/cph-1-53.pdf Accessed November 14, 2015.
- Goldberg RJ, Gore JM, Alpert JS, et al. Recent changes in attack and survival rates of acute myocardial infarction (1975 through 1981). The Worcester Heart Attack Study. JAMA 1986;255:2774-2779.
- Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)-A metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 2009;42:377-81.
- Statistical Software. Stata. http://www.stata.com
- Melanson SEF, Tanasijevic MJ, Jarolim P. Circulation. 2007; 116: e501-e504