The Impact of the Duration of Cardiac Troponin I Elevation on the Clinical Prognosis as Well as Incidence of New-Onset Atrial Fibrillation Respectively in Elderly Non-ST-Elevation Acute Myocardial Infarction Patients without PCI

Abstract

Objective

This study aimed to investigate the impact of the duration of cardiac troponin I (TnI) elevation on the prognosis and incidence of new-onset atrial fibrillation (NOAF) in elderly patients with non-ST-elevation acute myocardial infarction (NSTE-AMI).

Methods

A total of 383 NSTE-AMI patients ≥75 years old were enrolled in this study and divided into two groups: in 194 cases, the duration of TnI elevation was ≥14 days (group 1), and in 189 cases, the duration of TnI elevation was <14 days (group 2). The patients were followed up for 60 months. The effect of TnI on prognosis was studied by cohort. The primary endpoint was a composite endpoint of cardiovascular death, reinfarction, ischemic stroke, and hospitalization for heart failure, and the secondary endpoint was all-cause death. A case–control study design was adopted to analyze the influencing factors of NOAF occurrence in Group 1 and Group 2.

Results

The median duration of follow-up was 26 months. Multivariate Cox’s regression analysis revealed that the duration of TnI elevation ≥14 days and diuretic use were independent variables of the major composite endpoint (p < 0.01 for both), and the left ventricular ejection fraction and the duration of TnI elevation ≥14 days were independent related variables of all-cause death (p < 0.05). The duration of TnI elevation ≥14 days was correlated with the occurrence of NOAF, but, in the multivariate logistic regression model, only uric acid and high-sensitivity C-reactive protein were independently associated with NOAF (p < 0.05).

Conclusion

The duration of TnI elevation ≥14 days was the independent correlation factor of the major composite endpoint and all-cause death; high sensitivity C-reactive protein and uric acid are independent risk factors for NOAF.

Keywords:

• duration of TnI elevation
• the elderly
• non-ST-segment acute elevation acute myocardial infarction
• prognosis
• new-onset atrial fibrillation

Ethics Approval and Consent to Participate

The study was conducted in accordance with the Declaration of Helsinki (as was revised in 2013). The study was approved by Ethics Committee of the Beijing Hepingli Hospital (BJSHPLYY-IRB-KYXM-2021-05). Written informed consent was obtained from all participants.

Acknowledgments

We are particularly grateful to all the people who have given us help on our article.

Disclosure

The authors declare that they have no competing interests in this work.