Title Prognostic significance of biomarkers in predicting in-hospital all-cause mortality in elderly patients with acute myocardial infarction /
Authors Broslavskytė, Margarita ; Šerpytis, Rokas ; Navickas, Giedrius ; Glaveckaitė, Sigita ; Samalavičius, Robertas Stasys ; Šerpytis, Pranas
DOI 10.26717/BJSTR.2019.20.003462
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Is Part of Biomedical journal of scientific and technical research.. Westchester, IL : Biomedical Research Network. 2019, vol. 20, no. 3, p. 15095-15099
Keywords [eng] acute myocardial infarction ; all-cause hospital mortality ; biomarkers ; prognosis
Abstract [eng] Background: AMI is a common cause of death in elderly patients. Therefore, prognostic prediction has become crucially important part of the treatment process. Aim: We aimed to investigate prognostic significance of biomarkers and other clinical factors in predicting all-cause in-hospital mortality in patients older than 75 years with AMI. Materials and Methods: 2059 consecutive patients were retrospectively included in single center study. Participants were divided into groups based on their in-hospital mortality. The prognostic ability of biomarkers peak values was evaluated by using ROC curve and binary logistic regression analysis. Results: Among 2059 patients enrolled in this study, 1141 (55.4%) were woman, and 1060 (51.5%) were with a diagnosis of non-ST segment elevation myocardial infarction. The mean age (SD) of the study population was 81.97 (4.33) years. In-hospital mortality rate in our study was 13.3%. Peak Troponin I, BNP and hs-CRP concentrations were significantly higher in deceased patients (all p<0.01). The area under the ROC curve for Troponin I was 0.595, 0.653 for BNP and 0.664 for hs-CRP. BNP level >824.3 ng/l and hs-CRP level >78.7 g/l were disclosed as the best thresholds for mortality prediction in this age group. Using binary logistic regression, hs-CRP level >78.7 g/l (OR (95% CI), 2.68 (1.89-3.81)), stroke history (OR (95%CI), 2.3 (1.53-3.47)), BNP level >824.3 ng/l (OR (95% CI), 2.04 (1.43- 2.91)), in-hospital bleeding complications (OR (95% CI), 2.04 (1.27-3.28)) were identified as strongest independent predictors of in-hospital all-cause mortality. Conclusion: In-hospital mortality in elderly patients with acute myocardial infarction is 13.3%. Troponin I is the least useful biomarker in predicting mortality. Increased levels of hs-CRP, BNP, stroke history and the presence of any in-hospital bleeding complications were identified as reliable predictors of in-hospital mortality in the elderly population with acute myocardial infarction.
Published Westchester, IL : Biomedical Research Network
Type Journal article
Language English
Publication date 2019
CC license CC license description