Cardiovascular medications, high-sensitivity cardiac troponin T concentrations, and long-term outcome in non-ST segment elevation acute coronary syndrome
Authors' conclusion
Cardiovascular medications provide different prognostic benefit in patients with NSTE-ACS with elevated hs-cTnT, and there was some evidence of greater treatment effects regarding MAE along with higher hs-cTnT concentrations. However, hs-cTnT appears only to have limited value overall for customizing such treatments.
Study context
- Population
- NSTE-ACS with elevated high-sensitivity cardiac troponin >14 ng/L3 cohorts: n = 43,075, 40,162, 46,698
- Exposure
- Newly initiated betablockers, renin-angiotensin-aldosterone system (RAAS) inhibitors and statins vs no initiation, by high-sensitivity cardiac troponin T (hs-cTnT) concentration
- Outcome
- Long-term all-cause mortality and major adverse events (MAE), and interaction with hs-cTnT concentrations
Methodological detailsthree cohorts
- Three cohorts
Main finding
As reported in the abstract
Betablockers: risk reduction in all-cause mortality and MAE, respectively; no evidence of interaction with hs-cTnT
8 and 5%
RAAS inhibitors: risk reduction in all-cause mortality and MAE, respectively; weak interaction hs-cTnT and MAE (Pinteraction = 0.016); no increasing benefit at hs-cTnT >100 ng/L
13 and 8%
Statins: risk reduction in all-cause mortality and MAE, respectively; benefit across entire hs-cTnT range; weak interaction regarding MAE (Pinteraction = 0.011)
38 and 32%
Observational data: associations, not effects.
Original publication
Summarised from the published abstract; every number is checked against it