Tissue plasminogen activator on admission is an important predictor of 30-day mortality in patients with acute myocardial infarction undergoing primary angioplasty

Cheol Whan Lee, Jung Min Ahn, Duk Woo Park, Young Hak Kim, Myeong Ki Hong, Jae Kwan Song, Jae Joong Kim, Seong Wook Park, Hyun Sook Chi, Seung Jung Park

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Tissue plasminogen activator (tPA) is emerging as an important risk factor for coronary heart disease, but the association between tPA concentration and mortality in acute myocardial infarction (AMI) remains uncertain. We studied the relationship between tPA antigen level on admission and 30-day mortality in 226 consecutive patients with AMI undergoing primary angioplasty. Death within 30 days occurred in 13 patients (5.7%). The concentration of tPA was significantly higher among the 13 patients who died than among the 213 who survived (26.5 ± 16.3 versus 12.5 ± 8.5 ng/mL, p < 0.001). Compared with those in the lowest quartile (<9 ng/mL), patients in the highest quartile (>16 ng/mL) had a relative risk of subsequent death of 13.1 (p = 0.014). In a Cox regression model, a tPA concentration >19 ng/mL was independently associated with mortality (HR 12.1, 95% CI, 1.9-76.7, p = 0.001). This cutoff value had a 76.9% sensitivity and an 85.9% specificity for predicting 30-day mortality. tPA concentration was also higher in patients with severe heart failure (20.9 ± 14.2 ng/mL versus 11.7 ± 7.5 ng/mL, p = 0.001) or ventricular tachyarrhythmia (24.3 ± 13.9 ng/mL versus 12.2 ± 8.4 ng/mL, p = 0.001). In conclusions, elevated tPA antigen at initial presentation in patients with AMI was associated with higher short-term risk of death, suggesting that tPA may be a useful prognostic biomarker for the early risk stratification of these patients.

Original languageEnglish
Pages (from-to)327-332
Number of pages6
JournalAtherosclerosis
Volume196
Issue number1
DOIs
Publication statusPublished - 2008 Jan 1

Fingerprint

Tissue Plasminogen Activator
Angioplasty
Myocardial Infarction
Mortality
Antigens
Proportional Hazards Models
Tachycardia
Coronary Disease
Heart Failure
Biomarkers
Sensitivity and Specificity

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Lee, Cheol Whan ; Ahn, Jung Min ; Park, Duk Woo ; Kim, Young Hak ; Hong, Myeong Ki ; Song, Jae Kwan ; Kim, Jae Joong ; Park, Seong Wook ; Chi, Hyun Sook ; Park, Seung Jung. / Tissue plasminogen activator on admission is an important predictor of 30-day mortality in patients with acute myocardial infarction undergoing primary angioplasty. In: Atherosclerosis. 2008 ; Vol. 196, No. 1. pp. 327-332.
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abstract = "Tissue plasminogen activator (tPA) is emerging as an important risk factor for coronary heart disease, but the association between tPA concentration and mortality in acute myocardial infarction (AMI) remains uncertain. We studied the relationship between tPA antigen level on admission and 30-day mortality in 226 consecutive patients with AMI undergoing primary angioplasty. Death within 30 days occurred in 13 patients (5.7{\%}). The concentration of tPA was significantly higher among the 13 patients who died than among the 213 who survived (26.5 ± 16.3 versus 12.5 ± 8.5 ng/mL, p < 0.001). Compared with those in the lowest quartile (<9 ng/mL), patients in the highest quartile (>16 ng/mL) had a relative risk of subsequent death of 13.1 (p = 0.014). In a Cox regression model, a tPA concentration >19 ng/mL was independently associated with mortality (HR 12.1, 95{\%} CI, 1.9-76.7, p = 0.001). This cutoff value had a 76.9{\%} sensitivity and an 85.9{\%} specificity for predicting 30-day mortality. tPA concentration was also higher in patients with severe heart failure (20.9 ± 14.2 ng/mL versus 11.7 ± 7.5 ng/mL, p = 0.001) or ventricular tachyarrhythmia (24.3 ± 13.9 ng/mL versus 12.2 ± 8.4 ng/mL, p = 0.001). In conclusions, elevated tPA antigen at initial presentation in patients with AMI was associated with higher short-term risk of death, suggesting that tPA may be a useful prognostic biomarker for the early risk stratification of these patients.",
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Tissue plasminogen activator on admission is an important predictor of 30-day mortality in patients with acute myocardial infarction undergoing primary angioplasty. / Lee, Cheol Whan; Ahn, Jung Min; Park, Duk Woo; Kim, Young Hak; Hong, Myeong Ki; Song, Jae Kwan; Kim, Jae Joong; Park, Seong Wook; Chi, Hyun Sook; Park, Seung Jung.

In: Atherosclerosis, Vol. 196, No. 1, 01.01.2008, p. 327-332.

Research output: Contribution to journalArticle

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T1 - Tissue plasminogen activator on admission is an important predictor of 30-day mortality in patients with acute myocardial infarction undergoing primary angioplasty

AU - Lee, Cheol Whan

AU - Ahn, Jung Min

AU - Park, Duk Woo

AU - Kim, Young Hak

AU - Hong, Myeong Ki

AU - Song, Jae Kwan

AU - Kim, Jae Joong

AU - Park, Seong Wook

AU - Chi, Hyun Sook

AU - Park, Seung Jung

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N2 - Tissue plasminogen activator (tPA) is emerging as an important risk factor for coronary heart disease, but the association between tPA concentration and mortality in acute myocardial infarction (AMI) remains uncertain. We studied the relationship between tPA antigen level on admission and 30-day mortality in 226 consecutive patients with AMI undergoing primary angioplasty. Death within 30 days occurred in 13 patients (5.7%). The concentration of tPA was significantly higher among the 13 patients who died than among the 213 who survived (26.5 ± 16.3 versus 12.5 ± 8.5 ng/mL, p < 0.001). Compared with those in the lowest quartile (<9 ng/mL), patients in the highest quartile (>16 ng/mL) had a relative risk of subsequent death of 13.1 (p = 0.014). In a Cox regression model, a tPA concentration >19 ng/mL was independently associated with mortality (HR 12.1, 95% CI, 1.9-76.7, p = 0.001). This cutoff value had a 76.9% sensitivity and an 85.9% specificity for predicting 30-day mortality. tPA concentration was also higher in patients with severe heart failure (20.9 ± 14.2 ng/mL versus 11.7 ± 7.5 ng/mL, p = 0.001) or ventricular tachyarrhythmia (24.3 ± 13.9 ng/mL versus 12.2 ± 8.4 ng/mL, p = 0.001). In conclusions, elevated tPA antigen at initial presentation in patients with AMI was associated with higher short-term risk of death, suggesting that tPA may be a useful prognostic biomarker for the early risk stratification of these patients.

AB - Tissue plasminogen activator (tPA) is emerging as an important risk factor for coronary heart disease, but the association between tPA concentration and mortality in acute myocardial infarction (AMI) remains uncertain. We studied the relationship between tPA antigen level on admission and 30-day mortality in 226 consecutive patients with AMI undergoing primary angioplasty. Death within 30 days occurred in 13 patients (5.7%). The concentration of tPA was significantly higher among the 13 patients who died than among the 213 who survived (26.5 ± 16.3 versus 12.5 ± 8.5 ng/mL, p < 0.001). Compared with those in the lowest quartile (<9 ng/mL), patients in the highest quartile (>16 ng/mL) had a relative risk of subsequent death of 13.1 (p = 0.014). In a Cox regression model, a tPA concentration >19 ng/mL was independently associated with mortality (HR 12.1, 95% CI, 1.9-76.7, p = 0.001). This cutoff value had a 76.9% sensitivity and an 85.9% specificity for predicting 30-day mortality. tPA concentration was also higher in patients with severe heart failure (20.9 ± 14.2 ng/mL versus 11.7 ± 7.5 ng/mL, p = 0.001) or ventricular tachyarrhythmia (24.3 ± 13.9 ng/mL versus 12.2 ± 8.4 ng/mL, p = 0.001). In conclusions, elevated tPA antigen at initial presentation in patients with AMI was associated with higher short-term risk of death, suggesting that tPA may be a useful prognostic biomarker for the early risk stratification of these patients.

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