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Open Access 01-12-2022 | Myocardial Infarction | Research

Kinetics of 2 different high-sensitive troponins during targeted temperature management in out-of-hospital cardiac arrest patients with acute myocardial infarction: a post hoc sub-study of a randomised clinical trial

Authors: Alf Inge Larsen, Anders Morten Grejs, Simon Tilma Vistisen, Kristian Strand, Øyvind Skadberg, Anni Nørgaard Jeppesen, Christophe H. V. Duez, Hans Kirkegaard, Eldar Søreide

Published in: BMC Cardiovascular Disorders | Issue 1/2022

Abstract

Introduction

Short term hypothermia has been suggested to have cardio protective properties in acute myocardial infarction (AMI) by reducing infarct size as assessed by troponins. There are limited data on the kinetics of these biomarkers in comatose out-of-hospital cardiac arrest (OHCA) patients, with and without AMI, undergoing targeted temperature management (TTM) in the ICU.

Purpose

The aim of this post hoc analyses was to evaluate and compare the kinetics of two high-sensitivity cardiac troponins in OHCA survivors, with and without acute myocardial infarction (AMI), during TTM of different durations [24 h (standard) vs. 48 h (prolonged)].

Methods

In a sub-cohort (n = 114) of the international, multicentre, randomized controlled study “TTH48” we measured high-sensitive troponin T (hs-cTnT), high-sensitive troponin I (hs-cTnI) and CK-MB at the following time points: Arrival, 24 h, 48 h and 72 h from reaching the target temperature range of 33 ± 1 °C. All patients diagnosed with an AMI at the immediate coronary angiogram (CAG)—18 in the 24-h group and 25 in the 48-h group—underwent PCI with stent implantation. There were no stent thromboses.

Results

Both the hs-cTnT and hs-cTnI changes over time were highly influenced by the cause of OHCA (AMI vs. non-AMI). In contrast to non-AMI patients, both troponins remained elevated at 72 h in AMI patients. There was no difference between the two time-differentiated TTM groups in the kinetics for the two troponins.

Conclusion

In comatose OHCA survivors with an aetiology of AMI levels of both hs-cTnI and hs-cTnT remained elevated for 72 h, which is in contrast to the well-described kinetic profile of troponins in normotherm AMI patients. There was no difference in kinetic profile between the two high sensitive assays. Different duration of TTM did not influence the kinetics of the troponins.

Trial registration: Clinicaltrials.gov Identifier: NCT01689077, 20/09/2012.

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Title: Kinetics of 2 different high-sensitive troponins during targeted temperature management in out-of-hospital cardiac arrest patients with acute myocardial infarction: a post hoc sub-study of a randomised clinical trial
Authors: Alf Inge Larsen
Anders Morten Grejs
Simon Tilma Vistisen
Kristian Strand
Øyvind Skadberg
Anni Nørgaard Jeppesen
Christophe H. V. Duez
Hans Kirkegaard
Eldar Søreide
Publication date: 01-12-2022
Publisher: BioMed Central
Keywords: Myocardial Infarction
Temperature Management
Published in: BMC Cardiovascular Disorders / Issue 1/2022
Electronic ISSN: 1471-2261
DOI: https://doi.org/10.1186/s12872-022-02778-4

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Kinetics of 2 different high-sensitive troponins during targeted temperature management in out-of-hospital cardiac arrest patients with acute myocardial infarction: a post hoc sub-study of a randomised clinical trial

Abstract

Introduction

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Purpose

Methods

Results

Conclusion

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