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High-sensitive troponin T and N-terminal pro-B-type natriuretic peptide independently predict survival and cardiac-related events in adults with congenital heart disease.
- Source :
- European Journal of Cardiovascular Nursing; Jan2024, Vol. 23 Issue 1, p55-61, 7p
- Publication Year :
- 2024
-
Abstract
- Aims: High-sensitive troponin T (hs-TnT), N-terminal pro-B-type natriuretic peptide (NT-proBNP), and C-reactive protein (CRP) are established prognostic biomarkers for cardiovascular (CV) morbidity and mortality and frequently used in symptomatic and/or hospitalized adults with congenital heart disease (ACHD). Their prognostic value in clinically stable ACHD has not yet been well established. This study investigates the predictive value of hs-TnT, NT-proBNP, and CRP for survival and CV events in stable ACHD. Methods and results: In this prospective cohort study, 495 outpatient ACHD (43.9 ± 10.0 years, 49.1% female) underwent venous blood sampling including hs-TnT, NT-proBNP, and CRP. Patients were followed up for survival status and the occurrence of CV events. Survival analyses were performed with Cox proportional hazards regression analysis and Kaplan–Meier curves. During a mean follow-up of 2.8 ± 1.0 years, 53 patients (10.7%) died or reached a cardiac-related endpoint including sustained ventricular tachycardia, hospitalization with cardiac decompensation, ablation, interventional catheterization, pacer implantation, or cardiac surgery. Multivariable Cox regression revealed hs-TnT (P = 0.005) and NT-proBNP (P = 0.018) as independent predictors of death or cardiac-related events in stable ACHD, whilst the prognostic value of CRP vanished after multivariable adjustment (P = 0.057). Receiver-operator characteristic curve analysis identified cut-off values for event-free survival of hs-TnT ≤9 ng/L and NT-proBNP ≤200 ng/L. Patients with both increased biomarkers had a 7.7-fold (confidence interval 3.57–16.40, P < 0.001) higher risk for death and cardiac-related events compared with patients without elevated blood values. Conclusion: Subclinical values of hs-TnT and NT-proBNP are a useful, simple, and independent prognostic tool for adverse cardiac events and survival in stable outpatient ACHD. Registration: German Clinical Trial Registry DRKS00015248. Graphical Abstract [ABSTRACT FROM AUTHOR]
- Subjects :
- TROPONIN
C-reactive protein
BIOMARKERS
CONFIDENCE intervals
CONGENITAL heart disease
BLOOD collection
REGRESSION analysis
VENTRICULAR tachycardia
SURVIVAL analysis (Biometry)
KAPLAN-Meier estimator
DESCRIPTIVE statistics
CHI-squared test
PEPTIDE hormones
RECEIVER operating characteristic curves
LONGITUDINAL method
PROPORTIONAL hazards models
ADULTS
Subjects
Details
- Language :
- English
- ISSN :
- 14745151
- Volume :
- 23
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- European Journal of Cardiovascular Nursing
- Publication Type :
- Academic Journal
- Accession number :
- 174784070
- Full Text :
- https://doi.org/10.1093/eurjcn/zvad032