Coronary disease & ACSCohort study
Mortality After Procedural or Spontaneous Myocardial Infarction
- Cohort study
Conventional troponin I measured using the Architect methodology (Abbott)
Authors' conclusion
Mortality at 1 year was significantly increased after pMI and spMI with troponin peak >35× URL, whereas for troponin levels ≤35× only spMI had a relevant impact on mortality.
Study context
- Population
- Patients undergoing percutaneous coronary intervention (PCI) with chronic coronary syndrome (CCS) (baseline troponin ≤1× upper reference level (URL)) or acute spontaneous myocardial infarction (spMI), 2012–20208,515 CCS
- Participants
- 10,707 patients
- Exposure
- Procedural myocardial infarction (pMI) or spMI vs no MI
- pMIn = 913
- spMIn = 2,192
- Outcome
- All-cause death, across 3 strata of troponin elevation (>1-5×, >5-35×, >35× URL)
- Follow-up
- 1 year
Main finding
As reported in the abstract
All-cause mortality, troponin peak >35× URL
Each group vs No-MIAdjusted hazard ratio (95% CI)
pMI
4.40(1.59–12.2)
spMI
7.57(5.44–10.5)
Observational data: associations, not effects.
Further findings
| Outcome | No-MI | pMI | spMI |
|---|---|---|---|
| Troponin peak distribution (>1-5×, >5-35×, >35× URL) | |||
| >1-5× URL | Not reported in the abstract | 53% | 24% |
| >5-35× URL | Not reported in the abstract | 41% | 38% |
| >35× URL | Not reported in the abstract | 6% | 37% |
Original publication
Mortality After Procedural or Spontaneous Myocardial Infarction. J Am Coll Cardiol. Published 30 July 2024. doi:10.1016/j.jacc.2024.04.061
Summarised from the published abstract; every number is checked against it