TIMI IIIB研究课件.ppt

Spectrum of Acute Coronary Syndromes * Stable Angina Unstable Angina Non-Q wave MI Q wave MI ST Elevation MI Non ST Elevation ACS ECG - ST CK-MB Troponin CRP ECG - ST Cannon CP. 1999 TIMI IIIB: Troponin I vs. 42 Day Mortality 0-0.4 0.4-1.0 1.0-2.0 2.0-5.0 5.0-9.0 9.0 0 1 2 3 4 5 6 7 8 Death by 42 Days (%) cTnI at Baseline (ng/ml) 1.0 1.7 3.4 3.7 6.0 7.5 Risk Ratio 6.2 7.8 3.5 3.9 1.0 1.8 831 174 148 134 50 67 C2 p0.001 Antman et al. NEJM 1996;335: 1342-9. TIMI 11B cTnI SUBSTUDY Results Baseline cTnI and Outcomes by 14 Days P = 0.04 P = 0.0008 P 0.00001 P = 0.005 Moving to the 14 day events, we find that again cTnI is a strong indicator of higher risk for the composite outcome of death/MI or urgent revascularization with an absolute risk difference of nearly 14% between the troponin I positive and negative groups. Further, we see that an elevated baseline cTnI was predictive of increased risk of each component of the composite endpoint including both death and myocardial infarction. Similar to results from TIMI 3B, troponin I positive patients were at an over 3 fold higher risk of death than those with a normal baseline troponin. * * *