High troponin levels and increased risk of serious cardiac complications and death in Puerto Ricans with acute myocardial infarction

Autores/as

  • Juan Carlos Zevallos Universidad del Tolima
  • Roberto Zevallos Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, United States
  • Beatriz Collada Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, United States
  • Roberto Marticorena Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, United States
  • Reeni Pandya Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, United States
  • María del Mar Lucio Paredes Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, United States
  • Juan Manuel Lozano Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, United States

Palabras clave:

trombolytic therapy, hispanic, cerebrovascular event

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.

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

Publicado

2015-12-24

Número

Sección

Artículos de Investigación