High-sensitivity troponin T for prediction of left ventricular function and infarct size one year following ST-elevation myocardial infarction

BackgroundData relating high-sensitivity cardiac troponin T (hs-cTnT) to long-term myocardial function and infarct size in patients after ST-elevation myocardial infarction (STEMI) are lacking. We aimed to evaluate the use of early hs-cTnT concentrations for prediction of myocardial function and infarct size assessed by cardiac magnetic resonance imaging (CMR) one year following STEMI.MethodsSixty-six patients, revascularized by primary percutaneous coronary intervention (PCI) for first-time STEMI, were enrolled in this observational study. Serial hs-cTnT, creatine kinase (CK), high-sensitivity C-reactive protein (hs-CRP) and lactate dehydrogenase (LDH) levels were measured on admission, 6 h, 12 h, and 24 h post-PCI. Patients underwent CMR within the first week and 12 months thereafter.ResultsExcept for admission hs-cTnT, all single time point and peak hs-cTnT concentrations showed significant correlations with left ventricular ejection fraction (LVEF: r = − 0.404 to − 0.517, all ps < 0.01) and infarct size (IS: r = 0.421 to 0.700, all ps < 0.01) at baseline and follow-up. The area under the curve (AUC) of peak hs-cTnT was 0.82 (95% CI 0.71-0.92) for the prediction of decreased LVEF (< 55%) and 0.89 (95% CI 0.81-0.97) for the prediction of large IS (> 8%) at 12 months. The combination of all four biomarkers resulted in an AUC of 0.82 and 0.92 for the prediction of reduced LVEF and large IS at 12 months, respectively (both ps > 0.05).ConclusionIn stable STEMI patients successfully revascularized by primary PCI, serial and peak concentrations of hs-cTnT are closely correlated to long-term LVEF and IS. Combination of hs-cTnT with CK, hs-CRP, or LDH did not add any significant prognostic value as compared with hs-cTnT alone.