Detectable Troponin Levels Predict Poor Prognosis in Patients With Left Ventricular Dysfunction Undergoing Internal Defibrillator Implantation

Autor:	R N Tammy Czarnecki, Maliha Zahid, Scott Hogen, Ali F. Sonel, Morteza Amidi, Joseph P. McConnell, Alaa Shalaby
Rok vydání:	2007
Předmět:	Male medicine.medical_specialty medicine.medical_treatment Cardiomyopathy Risk Assessment Ventricular Dysfunction Left chemistry.chemical_compound Troponin T Predictive Value of Tests Internal medicine medicine Creatine Kinase MB Form Humans Aged Proportional Hazards Models Creatinine Chi-Square Distribution Ejection fraction Ischemic cardiomyopathy biology business.industry General Medicine Prognosis musculoskeletal system Implantable cardioverter-defibrillator medicine.disease Troponin Defibrillators Implantable chemistry Cohort biology.protein Cardiology Regression Analysis Cardiology and Cardiovascular Medicine business
Zdroj:	Pacing and Clinical Electrophysiology. 30:839-844
ISSN:	1540-8159 0147-8389
DOI:	10.1111/j.1540-8159.2007.00770.x
Popis:	Introduction:Troponin levels have been demonstrated to predict mortality in patients with cardiomyopathy. Implantable cardiac defibrillator (ICD) devices have been demonstrated to improve survival. It is not clear if ICDs would mitigate the negative outcome predicted by elevated troponin levels. Methods:We collected baseline blood samples for troponin T (TnT) and creatinine kinase-MB fraction in consecutive patients immediately before successful pectoral transvenous ICD implant. Patients were followed for total mortality. For analysis, patients were grouped by TnT detectablility (≥0.01 ng/mL). Results:Fifty-two men, aged 68 ± 10 years, were studied. Mean ejection fraction was 29 ± 12% and 65% had ischemic cardiomyopathy. Follow-up duration was 17 ± 8 months. None of the patients had abnormal creatinine kinase-MB fraction levels (1.7 ± 1.1 ng/mL). There were 37 patients with no detectable TnT (Group I) and 15 with detectable TnT (Group II). There was no difference between the two groups in terms of age (68 vs 69, P = NS), ejection fraction (30 vs 29%, P = NS), or proportion of patients with ischemic cardiomyopathy (68 vs 60%, P = NS). During follow-up 16 (31%) patients died. Patients in group I had mortality of 16% (6/37) compared to 67% mortality (10/15, P < 0.001) in group II. On multivariate analysis, detectable TnT remained an independent predictor of mortality (HR 4.5, CI 1.4–14.25, P = 0.01). Conclusion:In a cohort of patients with cardiomyopathy undergoing ICD implantation for standard clinical indications, presence of detectable TnT was associated with high mortality despite ICD implantation. TnT obtained before ICD implantation may be useful for risk stratification.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1e77acf1605fef513efd96561cd325bf https://doi.org/10.1111/j.1540-8159.2007.00770.x Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
Nepřihlášeným uživatelům se plný text nezobrazuje	K zobrazení výsledku je třeba se přihlásit.