You are on page 1of 2

1/5/2016

Thediagnosticandprognosticimpactoftheredefinitionofacutemyocardialinfarction:LessonsfromtheGlobalRegistryofAcuteCoronaryEvents(GRA

RSSFeeds

Mobile

Login |Register |Subscribe

Home

Articles&Issues

Collections

FreeCME

ForAuthors

AllContent

JournalInfo
Search

March2006 Volume151,Issue3,Pages654660

<PreviousArticle

Subscribe

MorePeriodicals

AdvancedSearch

NextArticle>
Accessthisarticleon

ScienceDirect

Thediagnosticandprognosticimpactoftheredefinitionof
acutemyocardialinfarction:LessonsfromtheGlobal
RegistryofAcuteCoronaryEvents(GRACE)
Preliminaryresultsofthisstudywerepresentedasanabstractatthe2001AnnualScientificSessionofthe
AmericanCollegeofCardiology,Orlando,FL,onMarch20,2001,andwerepublishedintheJAmCollCardiol
200137:358A.

ShaunG.Goodman,MD,MSc
,PhilippeGabrielSteg,MD,KimA.Eagle,MD,KeithA.A.Fox,MB,
ChB,FRCP,JosLpezSendn,MD,GillesMontalescot,MD,PhD,AndrzejBudaj,MD,PhD,BrianM.
Kennelly,MB,ChB,PhD,JoelM.Gore,MD,JeannaAllegrone,BA,ChristopherB.Granger,MD,Enrique
P.Gurfinkel,MD,PhD,fortheGRACEInvestigatorsm
m AcompletelistoftheGRACEInvestigatorsisincludedintheAppendixA.

ArticleTools
PDF(135KB)
DownloadImages(.ppt)
AboutImages&Usage

EmailArticle
AddtoMyReadingList
ExportCitation
CreateCitationAlert
CitedbyinScopus(0)

GuesteditorofthismanuscriptisElliottM.Antman,MD.
RequestPermissions
OrderReprints
(100minimumorder)
DOI:http://dx.doi.org/10.1016/j.ahj.2005.05.014

Purchasethisarticle(PDFIncluded)
BuyNow

Abstract

$31.50USD(24houraccess)

FullText

Images

Subscribetothistitle
SubscribeNow

References

Background
Theimpactandprognosticvalueoftheredefinitionofmyocardialinfarction(MI)withmoresensitivemarkers
havenotbeenevaluatedprospectivelyinalarge,lessselectedpopulationwithacutecoronarysyndrome
(ACS).

Methods
WeevaluatedtheattackandcasefatalityratesofMIbasedoninitialand/orpeakcreatinekinase(CK),
creatinekinaseMB(CKMB),andcardiactroponin(theupperlimitofnormal[ULN]wasdefinedaccording
tothelocalhospital'sstandard)inaprospectiveobservationalregistryof26 267patientswithACSadmitted
to106hospitalsin14countries.

Results
TheadditionofcardiactroponinpositivestatustoCKstatusasacriterionforthediagnosisofMIresultedin
asmanyas1in4additionalpatientsmeetingtheredefinedcriteria.Comparedwithpatientswithout
elevatedlevelsofCKandcardiactroponin,thecrudeoddsfordyingduringhospitalizationweresignificantly
higherforpatientswithelevatedtroponinbutnotCKlevelsofgreaterthanorequaltotheULN(oddsratio

http://www.ahjonline.com/article/S00028703(05)005120/abstract

RelatedArticles
Untanglingtheparadox:Obesityas
prognosticmarkerinprevalent
cardiovasculardisease
Publicationstage:InPressCorrectedProof
AmericanHeartJournal
Preoperativediagnosisand
postoperativeprognosisinpatients
undergoingcoronaryarterybypass
graftsurgery
AmericanHeartJournal,Vol.171,Issue1
Prognosticsignificanceofserum
creatinineanditschangepatternsin
patientswithacutecoronary
syndromes
AmericanHeartJournal,Vol.169,Issue3
PrognosisofelderlySTsegment
elevationmyocardialinfarction
patientsundergoingprimary
percutaneouscoronaryintervention
AmericanHeartJournal,Vol.168,Issue1
PrognosticimplicationsoftroponinT
andcreatinekinaseMBelevation
aftercoronaryarterybypassgrafting
AmericanHeartJournal,Vol.164,Issue5
ViewAll

1/2

1/5/2016

Thediagnosticandprognosticimpactoftheredefinitionofacutemyocardialinfarction:LessonsfromtheGlobalRegistryofAcuteCoronaryEvents(GRA

[OR]2.2,95%CI1.62.9),thosewithoutCKlevels>2timestheULN(OR2.8,95%CI2.23.5),andthose
withnonelevatedlevelsofCKMB(OR2.1,95%CI1.43.2).Theadditionofcardiactroponinpositivestatus
significantlyincreasedthemultivariableadjustedoddsforhospitaldeathinpatientswithCK2timesthe
ULN(OR1.6,95%CI1.22.1)butnotforpatientswithoutelevatedlevelsofCKorCKMB.

Conclusions
Theprognosticvalueofcardiactroponin,beyondthatsuppliedbyCKstatusorimportantbaseline
characteristics,assistsintheidentificationofpatientswithACSwhoareatincreasedriskfordeath.

Toaccessthisarticle,pleasechoosefromtheoptionsbelow

LogIn

Purchaseaccesstothisarticle
Onlineaccessfor24hours

Email/Username:
Password:

ClaimAccess

Rememberme

LogIn

Forgotpassword?

Register
Createanewaccount

IfyouareacurrentsubscriberwithSociety
MembershiporanAccountNumber,claimyour
accessnow.

Subscribetothistitle
Purchaseasubscriptiontogainaccesstothisand
allotherarticlesinthisjournal.

InstitutionalAccess
VisitScienceDirecttoseeifyouhaveaccessvia
yourinstitution.

ThisresearchwasfundedbyanunrestrictededucationalgrantfromAventisPharma,Bridgewater,NJ.
2006Mosby,Inc.PublishedbyElsevierInc.Allrightsreserved.

<PreviousArticle

March2006 Volume151,Issue3,Pages654660

NextArticle>

Copyright2015ElsevierInc.Allrightsreserved.|PrivacyPolicy|Terms&Conditions|AboutUs|Help&Contact
Thecontentonthissiteisintendedforhealthprofessionals.
Advertisementsonthissitedonotconstituteaguaranteeorendorsementbythejournal,Association,orpublisherofthequalityorvalueofsuchproductoroftheclaimsmadeforitbyits
manufacturer.

http://www.ahjonline.com/article/S00028703(05)005120/abstract

2/2