Author + information
- Ryan G. O'Malley,
- Marc Sabatine,
- Marc Bonaca,
- Sabina Murphy,
- Petr Jarolim,
- Michael Conrad,
- Christopher Cannon,
- Eugene Braunwald and
- David Morrow
Cardiac troponin (cTn) is an emerging prognostic biomarker in pts with stable ischemic heart disease (SIHD). New high-sensitivity assays are able to measure cTn at levels undetectable by current commercial assays. We assessed the prognostic performance of serial measurements of an investigational high-sensitivity cTnI assay in pts with SIHD.
We measured cTnI (Erenna, Singulex, 99th%ile 9 pg/mL, ‘sm-TnI') at 30 days and 4 mos in 2,664 pts who had been stable through 4 mos without recurrent events after an acute coronary syndrome in PROVE IT-TIMI 22. Our primary endpoint was cardiovascular death (CVD) or heart failure (HF). Pts were followed for 2 years on average.
Pts with ‘high’ (≥9 pg/mL) sm-TnI at 4 mos were at increased risk of CVD/HF at 2 years (5.1% v. 2.0%, p<0.001; HR 2.62, CI 1.69-4.06) including a higher rate of CVD (1.4% v. 0.4%, p=0.01; HR 2.80, CI 1.23-6.38) and HF (3.9% v. 1.6%, p<0.001; HR 2.63, CI 1.60-4.30), individually. Measured in series, pts with a newly elevated sm-TnI at 4 mos (‘low-high’) were at highest risk of CVD/HF at 2 years (6.0%; HR 3.28, CI 1.44-7.44, Figure). Pts with elevated sm-TnI at both follow-up lab draws also had an increased risk of CVD/HF (‘high-high’; 4.7%, HR 2.95, CI 1.73-5.02), as did those with sm-TnI elevated at 30 days but within normal range at 4 mos (‘high-low’; 3.3%, HR 2.16, CI 1.13-4.13, Figure).
Serial measurements of cTnI using an investigational high-sensitivity assay enhanced risk stratification for CVD/HF in pts with SIHD.
Moderated Poster Contributions
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.-10:45 a.m.
Session Title: The Best of Risk Stratification in SIHD
Abstract Category: 10. Chronic CAD/Stable Ischemic Heart Disease: Clinical
Presentation Number: 1110M-73
- 2013 American College of Cardiology Foundation