TY - JOUR
T1 - The Prognostic Value of Troponin-T in Out-of-Hospital Cardiac Arrest Without ST-Segment Elevation
T2 - A COACT Substudy
AU - Spoormans, Eva M.
AU - Lemkes, Jorrit S.
AU - Janssens, Gladys N.
AU - van der Hoeven, Nina W.
AU - Jewbali, Lucia S. D.
AU - Dubois, Eric A.
AU - Meuwissen, Martijn
AU - Rijpstra, Tom A.
AU - Bosker, Hans A.
AU - Blans, Michiel J.
AU - Bleeker, Gabe B.
AU - Baak, Remon
AU - Vlachojannis, Georgios J.
AU - Eikemans, Bob J. W.
AU - van der Harst, Pim
AU - van der Horst, Iwan C. C.
AU - Voskuil, Michiel
AU - van der Heijden, Joris J.
AU - Beishuizen, Albertus
AU - Stoel, Martin
AU - Camaro, Cyril
AU - van der Hoeven, Hans
AU - Henriques, José P.
AU - Vlaar, Alexander P. J.
AU - Vink, Maarten A.
AU - van den Bogaard, Bas
AU - Heestermans, Ton A. C. M.
AU - de Ruijter, Wouter
AU - Delnoij, Thijs S. R.
AU - Crijns, Harry J. G. M.
AU - Oemrawsingh, Pranobe V.
AU - Gosselink, Marcel T. M.
AU - Plomp, Koos
AU - Magro, Michael
AU - Elbers, Paul W. G.
AU - van der Pas, Stéphanie
AU - van Royen, Niels
N1 - Funding Information: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. This work was supported by unrestricted research grants from the Netherlands Heart Institute, Biotronik, and AstraZeneca. The study was conducted according to the principles of the Declaration of Helsinki and in accordance with the Medical Research Involving Human Subjects Act (WMO) and the statements of the Dutch Central Committee on Research Involving Human Subjects (CCMO). For all enrolled patients, deferred informed consent was obtained. Funding Information: This work was supported by unrestricted research grants from the Netherlands Heart Institute, Biotronik, and AstraZeneca. Publisher Copyright: © 2023 The Author(s)
PY - 2023
Y1 - 2023
N2 - Background: In out-of-hospital cardiac arrest (OHCA) without ST-elevation, predictive markers that can identify those with a high risk of acute coronary syndrome are lacking. Methods: In this post hoc analysis of the Coronary Angiography after Cardiac Arrest (COACT) trial, the baseline, median, peak, and time-concentration curves of troponin-T (cTnT) (T-AUC) in OHCA patients without ST-elevation were studied. cTnT values were obtained at predefined time points at 0, 3, 6, 12, 24, 36, 28, and 72 hours after admission. All patients who died within the measurement period were not included. The primary outcome was the association between cTnT and 90-day survival. Secondary outcomes included the association of cTnT and acute thrombotic occlusions, acute unstable lesions, and left ventricular function. Results: In total, 352 patients were included in the analysis. The mean age was 64 ± 13 years (80.4% men). All cTnT measures were independent prognostic factors for mortality after adjustment for potential confounders age, sex, history of coronary artery disease, witnessed arrest, time to BLS, and time to return of spontaneous circulation (eg, for T-AUC: hazard ratio, 1.44; 95% CI, 1.06-1.94; P = .02; P value for all variables ≤ .02). Median cTnT (odds ratio [OR], 1.58; 95% CI, 1.18-2.12; P = .002) and T-AUC (OR, 2.03; 95% CI, 1.25-3.29; P = .004) were independent predictors for acute unstable lesions. Median cTnT (OR, 1.62; 95% CI, 1.17-2.23; P = .003) and T-AUC (OR, 2.16; 95% CI, 1.27-3.68; P = .004) were independent predictors for acute thrombotic occlusions. CTnT values were not associated with the left ventricular function (eg, for T-AUC: OR, 2.01; 95% CI, 0.65-6.19; P = .22; P value for all variables ≥ .14) Conclusion: In OHCA patients without ST-segment elevation, cTnT release during the first 72 hours after return of spontaneous circulation was associated with clinical outcomes.
AB - Background: In out-of-hospital cardiac arrest (OHCA) without ST-elevation, predictive markers that can identify those with a high risk of acute coronary syndrome are lacking. Methods: In this post hoc analysis of the Coronary Angiography after Cardiac Arrest (COACT) trial, the baseline, median, peak, and time-concentration curves of troponin-T (cTnT) (T-AUC) in OHCA patients without ST-elevation were studied. cTnT values were obtained at predefined time points at 0, 3, 6, 12, 24, 36, 28, and 72 hours after admission. All patients who died within the measurement period were not included. The primary outcome was the association between cTnT and 90-day survival. Secondary outcomes included the association of cTnT and acute thrombotic occlusions, acute unstable lesions, and left ventricular function. Results: In total, 352 patients were included in the analysis. The mean age was 64 ± 13 years (80.4% men). All cTnT measures were independent prognostic factors for mortality after adjustment for potential confounders age, sex, history of coronary artery disease, witnessed arrest, time to BLS, and time to return of spontaneous circulation (eg, for T-AUC: hazard ratio, 1.44; 95% CI, 1.06-1.94; P = .02; P value for all variables ≤ .02). Median cTnT (odds ratio [OR], 1.58; 95% CI, 1.18-2.12; P = .002) and T-AUC (OR, 2.03; 95% CI, 1.25-3.29; P = .004) were independent predictors for acute unstable lesions. Median cTnT (OR, 1.62; 95% CI, 1.17-2.23; P = .003) and T-AUC (OR, 2.16; 95% CI, 1.27-3.68; P = .004) were independent predictors for acute thrombotic occlusions. CTnT values were not associated with the left ventricular function (eg, for T-AUC: OR, 2.01; 95% CI, 0.65-6.19; P = .22; P value for all variables ≥ .14) Conclusion: In OHCA patients without ST-segment elevation, cTnT release during the first 72 hours after return of spontaneous circulation was associated with clinical outcomes.
KW - acute coronary syndrome
KW - coronary angiography
KW - out-of-hospital cardiac arrest
UR - http://www.scopus.com/inward/record.url?scp=85176573402&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jscai.2023.101191
DO - https://doi.org/10.1016/j.jscai.2023.101191
M3 - Article
SN - 2772-9303
JO - Journal of the Society for Cardiovascular Angiography and Interventions
JF - Journal of the Society for Cardiovascular Angiography and Interventions
M1 - 101191
ER -