Stratificatie van STEMI patiënten op basis van biomarkers.

Al Ali, L. (2015) Stratificatie van STEMI patiënten op basis van biomarkers. thesis, Medicine.

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Abstract

Patients who have experienced a myocardial infarction could benefit greatly from custom preventive therapy based on their prognosis. In current practice the estimation of such a prognosis is primarily based on clinical parameters, despite clear indications in available literature that a strong relationship exists between cardiac biomarkers and outcome of cardiac function after an infarction. This retrospective study focused on finding a biomarker driven predictive model for patient prognosis after enduring a ST-elevated myocardial infarction (STEMI) in an existing database. This model would subsequently be validated retrospectively in another large-scale database of STEMI patients. We looked for associations between a model based on left ventricular ejection fraction (LVEF) and 30-day mortality as well as major adverse cardiac events (MACE) in 1-year follow-up in the database. To this end patients were divided in groups of relative prognosis. Subsequent analysis was performed to calculate the odds ratio (OR) and hazard ratio (HR) between these groups. The resulting model used peak values for troponin T (TnT) and creatin kinase – myocardial band (CK-MB) to predict LVEF. All three groups that had a prognosis with worse LVEF than normal had a significantly raised OR in both follow-ups when compared to the normal group. In 30-day and 1-year follow-up we found an OR of respectively 1.93 (P=0.004) and 1.59 (P=0.001) was found for the group with a mild prognosis. An OR of 3.24 (P=0.006) and 2.28 (P=0.009) was found up for those with a moderate prognosis and an OR of 9.72 (P<0.001) and 3.72 (P=0.005) for those with a severe prognosis. The predictive model found in this study is a valid tool for estimating the prognosis in STEMI patients for both 30-day all cause mortality and 1-year MACE.

Item Type:	Thesis (Thesis)
Supervisor name:	Harst, Prof. Dr. P van der
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 11:01
Last Modified:	25 Jun 2020 11:01
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/2152

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