N-terminal pro–brain natriuretic peptide for additional risk stratification in patients with non–ST-elevation acute coronary syndrome and an elevated troponin T: An Invasive versus Conservative Treatment in Unstable coronary Syndromes (ICTUS) substudy

2007 ◽  
Vol 153 (4) ◽  
pp. 485-492 ◽  
Author(s):  
Fons Windhausen ◽  
Alexander Hirsch ◽  
Gerard T. Sanders ◽  
Jan P. Hein Cornel ◽  
Johan Fischer ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Conservative Treatment ◽  
Risk Stratification ◽  
Brain Natriuretic Peptide ◽  
Troponin T ◽  
Elevated Troponin ◽  
Additional Risk ◽  
Coronary Syndrome ◽  
Coronary Syndromes ◽  
St Elevation

scholarly journals Cystatin C for Enhancement of Risk Stratification in Non–ST Elevation Acute Coronary Syndrome Patients with an Increased Troponin T

2009 ◽  
Vol 55 (6) ◽  
pp. 1118-1125 ◽  
Author(s):  
Fons Windhausen ◽  
Alexander Hirsch ◽  
Johan Fischer ◽  
P Marc van der Zee ◽  
Gerard T Sanders ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Renal Function ◽  
Risk Stratification ◽  
Cystatin C ◽  
Treatment Strategy ◽  
Troponin T ◽  
Invasive Treatment ◽  
Coronary Syndrome ◽  
The Third ◽  
St Elevation

Abstract Background: We assessed the value of cystatin C for improvement of risk stratification in patients with non–ST elevation acute coronary syndrome (nSTE-ACS) and increased cardiac troponin T (cTnT), and we compared the long-term effects of an early invasive treatment strategy (EIS) with a selective invasive treatment strategy (SIS) with regard to renal function. Methods: Patients (n = 1128) randomized to an EIS or an SIS in the ICTUS trial were stratified according to the tertiles of the cystatin C concentration at baseline. The end points were death within 4 years and spontaneous myocardial infarction (MI) within 3 years. Results: Mortality was 3.4%, 6.2%, and 13.5% in the first, second, and third tertiles, respectively, of cystatin C concentration (log-rank P < 0.001), and the respective rates of spontaneous MI were 5.5%, 7.5%, and 9.8% (log-rank P = 0.03). In a multivariate Cox regression analysis, the cystatin C concentration in the third quartile remained independently predictive of mortality [hazard ratio (HR), 2.04; 95% CI, 1.02–4.10; P = 0.04] and spontaneous MI (HR, 1.95; 95% CI, 1.05–3.63; P = 0.04). The mortality rate in the second tertile was lower with the EIS than with the SIS (3.8% vs 8.7%). In the third tertile, the mortality rates with the EIS and the SIS were, respectively, 15.0% and 12.2% (P for interaction = 0.04). Rates of spontaneous MI were similar for the EIS and the SIS within cystatin C tertiles (P for interaction = 0.22). Conclusions: In patients with nSTE-ACS and an increased cTnT concentration, mild to moderate renal dysfunction is associated with a higher risk of death and spontaneous MI. Use of cystatin C as a serum marker of renal function may improve risk stratification.

scholarly journals e0447 Combination of conventional biomarkers for risk stratification in non ST elevation acute coronary syndrome

Heart ◽  
2010 ◽  
Vol 96 (Suppl 3) ◽  
pp. A139-A139
Author(s):  
L. Bei ◽  
L. Zhiliang ◽  
Y. Quanneng ◽  
J. Wen ◽  
T. Danping
Keyword(s):  
Acute Coronary Syndrome ◽  
Risk Stratification ◽  
Coronary Syndrome ◽  
St Elevation ◽  
Elevation Acute Coronary Syndrome

scholarly journals Recent developments in diagnosis and risk stratification of non-ST-elevation acute coronary syndrome

2020 ◽  
Vol 28 (S1) ◽  
pp. 88-92
Author(s):  
G. W. A. Aarts ◽  
J. Q. Mol ◽  
C. Camaro ◽  
J. Lemkes ◽  
N. van Royen ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Risk Stratification ◽  
Coronary Syndrome ◽  
Recent Developments ◽  
St Elevation ◽  
Elevation Acute Coronary Syndrome
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