Risk stratification in patients with unstable angina and/or non-ST-elevation myocardial infarction by Troponin T and plasminogen-activator-inhibitor-1 (PAI-1)
Risk stratification in patients with unstable angina and/or non-ST-elevation myocardial infarction by Troponin T and plasminogen-activator-inhibitor-1 (PAI-1)
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DOI：
10.1016/j.thromres.2004.06.040
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发表时间：
2004-01-01
影响因子：
7.5
通讯作者：
Pogacar, V
中科院分区：
文献类型：
--
作者：
Sinkovic, A;Pogacar, V
背景：肌钙蛋白T(TnT)和纤溶酶原激活物-1(PAI-1)水平升高是急性冠脉综合征(ACS)预后不良的标志。为了对不稳定型心绞痛和/或非ST段抬高型心肌梗死(UA/NSTEMI)患者30天死亡和/或再梗死合并终点的风险进行分层，同时测定TNT和PAI-1水平。方法：检测113例UA/NSTEM患者入院后48h内血清TnT、PAI-1水平。如果复发的缺血和/或血流动力学和/或节律不稳定，则进行经皮冠状动脉介入治疗。结果：入院时PAI-1平均浓度(4.2+/-3.4U/ml比2.8+/-2.4U/m l，p4.0 U/m l，OR=5.78，95%CI=1.838~18.20)与入院前48h同时升高(OR=4.9，95%CI=1.569~15.385)，峰值PAI-1、TnT、GT同时升高(OR=4.9，95%CI=1.569~15.385)。结论：同时检测TNT和PAI-1将提供互补的预后信息，并使临床医生能够更有效地对UA/NSTEMI患者的风险进行分层。(C)2004爱思唯尔有限公司。保留所有权利。
Background: Increased Troponin T (TnT) and PAI-1 levels are markers of poor outcome in acute coronary syndromes (ACS). In order to stratify the risk for 30-day combined endpoint of mortality and/or reinfarction in unstable angina and/or non-ST-elevation myocardial infarction (UA/NSTEMI), TnT and PAI-1 levels were simultaneously assessed. Methods: The TnT and PAI-1 levels of 113 patients with UA/NSTEM were estimated within the first 48 h. Initial therapy was medical. Percutaneous coronary interventions were performed in case of recurrent ischemia and/or hemodynamic and/or rhythmic instability. Results: Statistically significant differences in mean admission PAI-1 (4.2 +/- 3.4 vs. 2.8 +/- 2.4 U/ml, p4.0 U/ml (OR=5.78, 95%CI=1.838-18.20) and with simultaneously increased peak PAI-1 > 3.5 U/ml and TnT > 0.1 mug/l within the first 48 h (OR=4.9, 95%CI=1.569-15.385). Conclusions: Simultaneous assessment of TnT and PAI-1 would provide complementary prognostic information and enable clinicians to stratify risk more effectively among patients with UA/ NSTEMI. (C) 2004 Elsevier Ltd. All rights reserved.