Background: The prognostic implications of the admission cTnI level and D2B time combined on in-hospital and 1-year heart failure (HF) and mortality in STEMI patients undergoing a primary percutaneous coronary intervention (PCI) are remain uncertain.
Methods and Results: We divided the consecutive 1485 STEMI patients who underwent PCI from January 2015 to October 2019 at our hospital into three groups based on their admission cTnI levels: normal group (< 0.1 ng/mL), middle group (0.1 to less than 3 ng/mL), and high group (≥ 3 ng/mL) and into two groups by their D2B times: > 90 min (> 90-D2B) and ≤ 90 min (≤ 90-D2B). During the in-hospital and 1-year follow-up periods, the incidence of composite clinical events increased significantly with the increase in the admission cTnI level (p < 0.05). In-hospital, the composite rate of death and HF events was significantly higher in the > 90-D2B group compared to the ≤ 90-D2B group (p = 0.006), but its influence disappeared in the 1-year follow-up (p > 0.05). A multivariable logistic analysis revealed that, in the ≤ 90-D2B group, with the exception of the cTnI ≥ 3 ng/mL patients, the cTnI level had no effect on in-hospital or 1-year outcomes; in > 90-D2B group, cTnI ≥ 3ng/mL increased outcomes in both periods.
Conclusion: High cTnI levels (≥ 3 ng/mL) on admission are independent of the D2B time for predicting in-hospital and 1-year cardiac events in STEMI patients undergoing PCI.
Keywords: cardiac troponin I, acute myocardial infarction, door-to-balloon time, cardiac death, heart failure