High sensitive troponin is associated with high risk clinical profile and outcome in acute heart failure.

Link to article at PubMed

Related Articles

High sensitive troponin is associated with high risk clinical profile and outcome in acute heart failure.

Cardiol J. 2015 Sep 28;

Authors: Diez M, Talavera ML, Conde DG, Campos R, Acosta A, Trivi MS

BACKGROUND: The aim of the study was to evaluate the value of high sensitivity cardiac troponin (hs-cTn) for identifying high-risk patients.
METHODS AND RESULTS: 187 patients admitted with acute heart failure (without myocardialinfarction) were consecutively included; hs-cTn was measured at admission; therelation between elevated hs-cTn and the clinical outcome during hospitalization and at90 days was analyzed;93% (n=174) had hs-cTn above the maximal normal value (14ng/L); median hs-cTnwas 42ng/L (IQR 24-81). Patients with ejection fraction (EF) ≤45% had higher hs-cTnvalues (p=0.0004). Patients with low cardiac output syndrome (LCOS) or shock had higher troponin levels compared with those with less severe clinical presentations (p=0.004). Patients who required inotropic presented higher troponin values (p=0.002),troponin values were also higher in those requiring complex therapies (intra-aorticballoon pump, mechanical ventilation or hemodialysis, p=0.002). At 90-day follow-up,28 patients died (15,5%) and 27 rehospitalizations occurred (55 events). The risk ofevents was greater in patients with hs-cTn>42ng/L (0.021), low blood pressure atadmission (p=0.002), LCOS or shock (p<0.0001), EF≤45% (p=0.005) and inotropic use(p<0.0001). In multivariate analysis, only inotropic agents requirements was associated independently with high risk of death or rehospitalizations at 90 days (p=0.007).
CONCLUSIONS: Elevation of hs-cTn is a finding almost constant in patients withde compensated heart failure. In subjects with higher troponin levels ventricular dysfunction is frequent. The use of hs-cTn for risk stratification at admission helps toidentify populations with poor outcome during hospitalization and higher risk of death or rehospitalizations during follow-up who will require rapid implementation of an aggressive treatment.

PMID: 26412605 [PubMed - as supplied by publisher]

Leave a Reply

Your email address will not be published.