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Contrasting the potential benefits of early invasive coronary angiography in acute and chronic myocardial injury patterns.

التفاصيل البيبلوغرافية
العنوان: Contrasting the potential benefits of early invasive coronary angiography in acute and chronic myocardial injury patterns.
المؤلفون: Joanne Eng-Frost, Simon Rocheleau, Kristina Lambrakis, Ehsan Khan, Anke van den Merkhof, Cynthia Papendick, Sam Lehman, Brian Chiang, Naomi Wattchow, Simon Steele, Scott Lorensini, Michael McCann, Kate George, Julian Vaile, Carmine De Pasquale, John French, Derek Chew
المصدر: PLoS ONE, Vol 18, Iss 6, p e0286157 (2023)
بيانات النشر: Public Library of Science (PLoS), 2023.
سنة النشر: 2023
المجموعة: LCC:Medicine
LCC:Science
مصطلحات موضوعية: Medicine, Science
الوصف: BackgroundIn cases of evolving myocardial injury not definitively attributed to coronary ischaemia precipitated by plaque rupture, referral for invasive coronary angiography (ICA) may be influenced by observed troponin profiles. We sought to explore association between early ICA and elevated high-sensitivity troponin T (hs-cTnT) concentrations with and without dynamic changes, to examine if there may be a hs-cTnT threshold associated with benefit from an initial ICA strategy.MethodsUsing published studies (hs-cTnT study n = 1937, RAPID-TnT study n = 3270) and the Fourth Universal Definition of Myocardial Infarction (MI), index presentations of patients with hs-cTnT concentrations 5-14ng/L were classified as 'non-elevated' (NE). Hs-cTnT greater than upper reference limit (14ng/L) were classified as 'elevated hs-cTnT with dynamic change' (encompassing acute myocardial injury, Type 1 MI, and Type 2 MI), or 'non-dynamic hs-cTnT elevation' (chronic myocardial injury). Patients with hs-cTnT ResultsAltogether, 3620 patients comprising 837 (23.1%) with non-dynamic hs-cTnT elevations and 332 (9.2%) with dynamic hs-cTnT elevations were included. Primary outcome was significantly higher with dynamic and non-dynamic hs-cTnT elevations (Dynamic: HR: 4.13 95%CI:2.92-5.82; pConclusionEarly ICA appears to portend benefit in hs-cTnT elevations with and without dynamic changes, and at lower hs-cTnT threshold in non-dynamic hs-cTnT elevation. Differences compel further investigation.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 1932-6203
Relation: https://doaj.org/toc/1932-6203
DOI: 10.1371/journal.pone.0286157
URL الوصول: https://doaj.org/article/1eccdcb75ca04cd5994ef918c7e98d0c
رقم الأكسشن: edsdoj.1eccdcb75ca04cd5994ef918c7e98d0c
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:19326203
DOI:10.1371/journal.pone.0286157