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￭ S-139 ￭
Predictive value of low T3 and subclinical myocardial injury for long-term clinical outcomes
Department of Internal Medicine, Chosun University School of Medicine, Gwangju
*Young-Min Lee, Dong-Hyun Choi
Background: Low triiodothyronine (T3) levels and subclinical myocardial injury may be associated with adverse cardiac and cerebrovascular (CCV) events in individuals without clinically apparent coronary heart disease (CHD). The aim of this study was to determine the associations of a low T3 lev- el and subclinical myocardial injury with the development of adverse CCV events in individuals without clinically apparent CHD. Methods: T3 and high-sensitivity cardiac troponin T (hs-cTnT) levels were analyzed in 250 chest pain patients free of CHD and heart failure.The primary endpoint was the composite of sudden cardiac death (SCD), ischemic stroke, newly developed atrial fibrillation (AF), pericardial effusion, and thrombosis. Results:
Throughout a mean follow-up of 15.6 months, the primary endpoint happened in 17 (6.8%) patients. Kaplan-Meier analysis disclosed a notably higher overall occurrence rate in patients with hs-cTnT levels ≥0.014 ng/mL and in patients with T3 ＜60 ng/dL. An exaggerated hazard was observed in pa- tients with combined high hs-cTnT and low T3. After adjustment, the HR for overall events in patients with high hs-cTnT/low T3 vs. normal hscTnT/T3 was 11.72 (95% CI: 2.83-48.57, p＝0.001). Conclusions: In chest pain patients without clinically obvious CHD, high hs-cTnT combined with low T3 was associated with adverse cardiac/CCV events and was an independent predictor of overall events even after adjustment. These data sug- gest the importance of systemic factors such as low T3 syndrome in the development of adverse cardiac/CCV events beyond advancing clinical athero- sclerotic coronary disease in chest pain patients.
￭ S-140 ￭
Prediction of infarct transmurality from CRP and MPVin patients with STEMI
1Internal Medicine, Chosun University School of Medicine, Gwangju, Korea, 2Department of Radiology, Chosun University School of Medicine, Gwangju, Korea
*Bo-Bae Kim1, DongHun Kim 2, Dong-Hyun Choi1
The aim of this study was to evaluate the relationship between C-reactive protein (CRP) level or mean platelet volume (MPV) and infarct transmurality in patients with ST-elevation myocardial infarction (STEMI). High C-reactive protein (CRP) and mean platelet volume (MPV) levels are associated with poor prognosis in patients with ST-segment elevation myocardial infarction (STEMI). We retrospectively reviewed CRP level, MPV, and infarct transmurality in 112 STEMI patients who were assessed by contrast-enhanced cardiac magnetic resonance imaging. When cut-off peak CRP level and MPV were set at 2.35 mg/dL and 7.3 fL using receiver operating characteristic curves, sensitivity was 67.3/69.2% and specificity was 76.7/76.7% for differentiating between the groups with and without transmural involvement. Peak CRP level, MPV, peak creatine kinase-MB (CK-MB) level, and peak high sensitivity cardiac troponin T (hs-cTnT) level had comparable predictive valuesfor transmural involvement (area under the curve, 0.749, 0.761, 0.680, and 0.696, respectively). High peak CRP level and MPV were independent predictors of transmural involvement after adjusting for peak CK-MB level, peak hs-cTnT level, baseline thrombolysis in myocardial infarction flow grade, and left ventricular ejection fraction (odds ratio: 5.16/5.42, 95%
CI 1.84-14.50/2.03-14.47, p＝0.002/0.001, respectively) in logistic regression analysis. The results of this study show that peak CRP level and MPV were predictive markers for transmural involvement; their predictive power for transmural involvement was independent of and comparable to that of peak CK-MB and hs-cTnT levels.
