Coronary disease & ACSSecondary analysis
The effect of zalunfiban on high sensitivity cardiac troponin and the association with clinical outcomes in patients with STEMI
- prespecified analysis
- core laboratory measurements
Authors' conclusion
Among patients with STEMI, more elevated concentrations of hs-cTnT are associated with worse measures of reperfusion and higher-risk for short-term death or heart failure. A single dose of zalunfiban at first medical contact reduced MI size.
Study context
- Population
- Patients with ST-segment elevation myocardial infarction (STEMI) treated with zalunfiban or placebo who had core laboratory hs-cTnT measurements
- Comparison
- zalunfiban compared to placebo; association of hs-cTnT concentrations with reperfusion measures and clinical outcomes
Primary result
As reported in the abstract
Resolution of ST deviation and Q wave development by hs-cTnT at presentation · presentation
More elevated hs-cTnT associated with less resolution of ST deviation
P = .006
More elevated hs-cTnT associated with more frequent Q wave development
P < .001
Further findings
| Outcome | OR | P value |
|---|---|---|
| Clinical outcomes by hs-cTnT at 24 hours · 30 days — per log unit increase in hs-cTnT at 24 hours · all-cause death · multivariable analyses | 1.83 | P = 0.03 |
| Clinical outcomes by hs-cTnT at 24 hours · 30 days — per log unit increase in hs-cTnT at 24 hours · cardiovascular death · multivariable analyses | 1.83 | P = 0.03 |
| Clinical outcomes by hs-cTnT at 24 hours · 30 days — per log unit increase in hs-cTnT at 24 hours · heart failure · multivariable analyses | 2.74 | P < 0.001 |
- Clinical outcomes by hs-cTnT at 24 hours — Higher hs-cTnT at 24 hours associated with composite of death and heart failure
- P < .001
Angiographic thrombus grade and epicardial and myocardial perfusion by hs-cTnT at presentation
- More elevated hs-cTnT associated with higher thrombus grade and worse epicardial and myocardial perfusion
- all P < .05
hs-cTnT and hs-cTnT determined Myocardial Infarction (MI) size · 24 hours
- zalunfiban had lower hs-cTnT compared to placebo
- P = 0.04
- Across multiples ≥ 10 to ≥ 1,000 times elevation, zalunfiban resulted in smaller hs-cTnT determined MI size
Original publication
The effect of zalunfiban on high sensitivity cardiac troponin and the association with clinical outcomes in patients with STEMI. Am Heart J. Published 16 June 2026. doi:10.1016/j.ahj.2026.107513
Summarised from the published abstract; every number is checked against it