Supplementary Material for: Different Prognostic Significance of Cardiac Troponin at Presentation and Peak Cardiac Troponin in Patients with Non-ST Segment Elevation Myocardial Infarction

Objectives: Non-ST elevation myocardial infarction (NSTEMI) is one of the most common manifestations of acute coronary syndromes (ACS). We evaluated the prognostic role of cardiac troponin I (cTnI) at presentation and peak cardiac troponin I in patients with NSTEMI. Methods: We consecutively enrolled 215 subjects presenting with NSTEMI. Subjects were followed up for 1 year. cTnI at presentation and the peak value of cTnI were measured. The primary end point was defined as cardiovascular death, readmission to hospital with heart failure and new ACS. Results: The subjects who presented the primary end point (49 subjects) had significantly increased values of peak cTnI compared to subjects free of cardiovascular events [7.19 (2.97-21.32) vs. 4.09 (1.18-11.85) ng/l; p = 0.002]. Nevertheless, cTnI at presentation did not differ between subjects who presented the primary end point and those free of events (p = 0.39). Multivariate Cox regression analysis after adjustment for confounders revealed by the univariate analysis showed that for an increase in peak cTnI from 1 to 10 ng/l, there is a 60% anticipated increase in the relative risk to present the primary end point (p = 0.04). Conclusion: These findings documented the different prognostic significance of cTnI at presentation and peak cTnI in patients presenting with NSTEMI, and highlighted the importance of monitoring the levels of cTnI in this high-risk population.

研究目的：非ST段抬高型心肌梗死（Non-ST elevation myocardial infarction, NSTEMI）是急性冠脉综合征（acute coronary syndromes, ACS）最常见的临床表现之一。本研究旨在评估非ST段抬高型心肌梗死患者就诊时的心肌肌钙蛋白I（cardiac troponin I, cTnI）水平及峰值心肌肌钙蛋白I水平的预后价值。
研究方法：本研究连续纳入215例因非ST段抬高型心肌梗死就诊的受试者，对其进行为期1年的随访。检测所有受试者的就诊时cTnI水平及峰值cTnI水平。本研究的主要终点定义为心血管死亡、因心力衰竭再次住院以及新发急性冠脉综合征。
研究结果：发生主要终点的受试者共49例，其峰值cTnI水平显著高于未发生心血管事件的受试者[7.19（2.97~21.32）vs. 4.09（1.18~11.85）ng/l；p=0.002]。然而，发生主要终点者与未发生事件者的就诊时cTnI水平并无显著差异（p=0.39）。经单变量分析识别混杂因素并校正后进行多变量Cox回归分析显示，当峰值cTnI从1 ng/l升至10 ng/l时，发生主要终点的相对风险预计升高60%（p=0.04）。
研究结论：本研究结果证实，非ST段抬高型心肌梗死患者的就诊时cTnI与峰值cTnI具有不同的预后意义，并强调了在这一高危人群中监测cTnI水平的重要性。