Usefulness of High-Sensitivity Cardiac Troponin T to Predict Long-Term Outcome in Patients with Hypertrophic Cardiomyopathy.

Autor: Gommans DHF; Department of Cardiology , Radboud University Medical Center; Department of Cardiology, Rijnstate Ziekenhuis Arnhem. Electronic address: frank.gommans@radboudumc.nl., Cramer GE; Department of Cardiology , Radboud University Medical Center., Fouraux MA; Department of Clinical Chemistry, Albert Schweitzer Hospital., Heijmans S; Department of Cardiology , Radboud University Medical Center; Department of Cardiology, Rijnstate Ziekenhuis Arnhem., Michels M; Department of Cardiology, Erasmus Medical Center., Timmermans J; Department of Cardiology , Radboud University Medical Center., Verheugt FWA; Department of Cardiology , Radboud University Medical Center., de Boer RA; Department of Cardiology, University Medical Center Groningen., Kofflard MJM; Department of Cardiology, Albert Schweitzer Hospital., Brouwer MA; Department of Cardiology , Radboud University Medical Center.
Jazyk: angličtina
Zdroj: The American journal of cardiology [Am J Cardiol] 2021 Aug 01; Vol. 152, pp. 120-124. Date of Electronic Publication: 2021 Jun 12.
DOI: 10.1016/j.amjcard.2021.04.040
Abstrakt: Since the first report of an association between cardiac troponin (cTn) and adverse outcome in hypertrophic cardiomyopathy (HD), there is a paucity in confirmative data. We performed a prospective, prespecified 5-year follow-up cohort study of 135 HC patients who participated in a national multicenter project and underwent clinical evaluation, MRI (cine, LGE and T2-weighted imaging) and biomarker assessment (high-sensitivity cTnT (hs-cTnT), N-terminal pro-B-type natriuretic peptide, soluble tumorgenicity suppressor-2, Galectin-3, Growth differentiation factor-15, C-terminal Propeptide of Type I Collagen (CICP)). An elevated hs-cTnT concentration was defined as ≥14ng/L. Follow-up was systematically performed for the primary endpoint: a composite of sudden cardiac death, heart failure related death, stroke-related death, heart failure hospitalization, hospitalization for stroke, spontaneous sustained ventricular tachycardia (VT) or appropriate ICD discharge, and progression to NYHA class III-IV. Elevated hs-cTnT was present in 33 of 135 (24%) HC patients. During a median follow-up of 5.0 years (IQR: 4.9-5.1) 18 patients reached the primary endpoint. Using Cox regression analysis, elevated hs-cTnT was univariately associated with the primary endpoint (HR: 3.4 (95%CI: 1.4-8.7, p=0.009). Also female sex, previous syncope, previous non-sustained VT, reduced LV ejection fraction (<50%) and CICP were associated with the primary endpoint. In multivariable analysis, elevated hs-cTnT remained independently associated with outcome (aHR: 4.7 (95%CI: 1.8-12.6, p = 0.002). In conclusion, this 5-year follow-up study is the first to prospectively confirm the association of elevated hs-cTnT and adverse outcomes. In addition to established clinical variables, cTn seems the biomarker of interest to further improve risk prediction in HC, which should be evaluated in larger prospective registries.
(Copyright © 2021 The Author(s). Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: