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Troponin T levels in patients with acute heart failure: clinical and prognostic significance of their detection and release during hospitalisation.
- Source :
-
Clinical research in cardiology : official journal of the German Cardiac Society [Clin Res Cardiol] 2012 Aug; Vol. 101 (8), pp. 663-72. Date of Electronic Publication: 2012 Mar 10. - Publication Year :
- 2012
-
Abstract
- Aims: Myocardial injury during an episode of acute heart failure (AHF) may be important for patents' outcome. We hypothesised that an increase of cardiac troponin levels (cTnT) during hospitalisation, in patients with undetectable levels on admission (cTnT release), may be a more specific marker of myocardial damage. With this aim, we assessed the clinical and prognostic significance of high serum cTnT levels at the time of admission and that of cTnT release in 198 consecutive patients admitted for AHF and with no signs of acute coronary syndrome.<br />Methods and Results: cTnT levels were serially measured at the time of admission, and after 6 and 12 h, in 198 consecutive patients admitted for AHF and with no signs of acute coronary syndrome. cTnT was detectable (>0.01 ng/mL) in 102 patients (52 %) and positive for myocardial necrosis (>0.03 ng/mL) in 78 patients (39 %). Negative cTnT at the time of admission became positive at 6 and/or 12 h in 36 (18 %) patients. Patients with increased cTnT levels were more likely to have coronary artery disease, hypertension, diabetes, and renal dysfunction. During a median follow-up duration of 247 days (IQR 96-480 days), the detection of increased cTnT levels was associated with a higher rate of all-cause deaths and, for cTnT release, all-cause death and cardiovascular rehospitalisation rate. CTnT release was an independent predictor of all-cause death and cardiovascular rehospitalisation, along with glomerular filtration rate, and the administration of inotropic agents during the initial hospitalisation.<br />Conclusions: Increased cTnT levels are a frequent finding in patients with AHF. They are more likely to occur in patients with comorbidities and are associated with poorer outcomes. cTnT release is an independent predictor of poorer outcomes.
- Subjects :
- Acute Disease
Biomarkers blood
Comorbidity
Female
Heart Failure blood
Humans
Italy epidemiology
Male
Myocardial Stunning blood
Prevalence
Prognosis
Reproducibility of Results
Risk Assessment
Sensitivity and Specificity
Survival Analysis
Survival Rate
Heart Failure diagnosis
Heart Failure mortality
Myocardial Stunning diagnosis
Myocardial Stunning mortality
Patient Discharge statistics & numerical data
Troponin T blood
Subjects
Details
- Language :
- English
- ISSN :
- 1861-0692
- Volume :
- 101
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Clinical research in cardiology : official journal of the German Cardiac Society
- Publication Type :
- Academic Journal
- Accession number :
- 22407461
- Full Text :
- https://doi.org/10.1007/s00392-012-0441-5