Background: Among patients with acute coronary syndrome, elevated cardiac trop onin and creatine phosphokinase MB fraction levels have both prognostic and diag nostic values. However, in hospitalized patients, cardiac...Background: Among patients with acute coronary syndrome, elevated cardiac trop onin and creatine phosphokinase MB fraction levels have both prognostic and diag nostic values. However, in hospitalized patients, cardiac biomarkers are measure d in a variety of clinical situations including but not limited to acute coronar y syndrome. Moreover, these patients may have elevated troponin levels with no increase in creatine phosphokinase MB fraction levels. Objective: To evaluate the cardiovas cular outcome of acutely ill, hospitalized patients with minimal troponin I incr ease with normal creatine phosphokinase MB fraction. Methods: We identified 64 p atients retrospectively from our database with minimal troponin I increase and n ormal creatine phosphokinase MB fraction hospitalized between November 1998 and April 2000. Discharged patients were questioned about re hospitalization for my ocardial infarction, unstable coronary syndrome, congestive heart failure and pe rcutaneous coronary intervention by means of a structured questionnaire. For tho se patients who died during hospitalization, data were collected from hospital r ecords. For patients who died at home or at a different institution, a sur vivi ng relative completed the questionnaire. Primary outcomes were death, myocardial infarction and the need for revascularization or re hospitalization. Results: Composite endpoint of death, myocardial infarction, percutaneous coronary interv ention or coronary artery bypass grafting and re hospitalization for cardiac ca use occurred in 35.95%of patients within 1 year. Conclusions: There is a signif icant composite event rate of death, myocardial infarction or re hospitalizatio n for cardiac causes in acutely ill, hospitalized patients with normal creatine phosphokinase MB fraction and minimally elevated troponin I, regardless of the c ause for hospitalization.展开更多
文摘Background: Among patients with acute coronary syndrome, elevated cardiac trop onin and creatine phosphokinase MB fraction levels have both prognostic and diag nostic values. However, in hospitalized patients, cardiac biomarkers are measure d in a variety of clinical situations including but not limited to acute coronar y syndrome. Moreover, these patients may have elevated troponin levels with no increase in creatine phosphokinase MB fraction levels. Objective: To evaluate the cardiovas cular outcome of acutely ill, hospitalized patients with minimal troponin I incr ease with normal creatine phosphokinase MB fraction. Methods: We identified 64 p atients retrospectively from our database with minimal troponin I increase and n ormal creatine phosphokinase MB fraction hospitalized between November 1998 and April 2000. Discharged patients were questioned about re hospitalization for my ocardial infarction, unstable coronary syndrome, congestive heart failure and pe rcutaneous coronary intervention by means of a structured questionnaire. For tho se patients who died during hospitalization, data were collected from hospital r ecords. For patients who died at home or at a different institution, a sur vivi ng relative completed the questionnaire. Primary outcomes were death, myocardial infarction and the need for revascularization or re hospitalization. Results: Composite endpoint of death, myocardial infarction, percutaneous coronary interv ention or coronary artery bypass grafting and re hospitalization for cardiac ca use occurred in 35.95%of patients within 1 year. Conclusions: There is a signif icant composite event rate of death, myocardial infarction or re hospitalizatio n for cardiac causes in acutely ill, hospitalized patients with normal creatine phosphokinase MB fraction and minimally elevated troponin I, regardless of the c ause for hospitalization.
