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

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

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Juan Carlos Zevallos
Roberto Zevallos
Beatriz Collada
Roberto Marticorena
Reeni Pandya
María del Mar Lucio Paredes
Juan Manuel Lozano
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.

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