Minor myocardial damage detected by troponin T is a powerful predictor of long-term prognosis in patients with acute decompensated heart failure
| Autor: | Natalia Augier, Eduardo F. Farias, Eduardo R. Perna, Eloisa Jantus, Stella M. Macín, Rolando Pantich, Monica Brizuela, Nelson Ríos, Pablo Alvarenga, Fernanda Medina, Juan P. Cimbaro Canella |
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| Rok vydání: | 2005 |
| Předmět: |
Male
Acute coronary syndrome medicine.medical_specialty Acute decompensated heart failure Exacerbation Heart disease Heart Ventricles Myocardial Ischemia Ventricular Function Left Electrocardiography Troponin T Troponin complex Predictive Value of Tests Internal medicine medicine Humans Hospital Mortality Prospective Studies Aged Heart Failure Proportional hazards model business.industry Middle Aged Prognosis medicine.disease Surgery Echocardiography Heart failure Acute Disease Disease Progression Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | International Journal of Cardiology. 99:253-261 |
| ISSN: | 0167-5273 |
| DOI: | 10.1016/j.ijcard.2004.01.017 |
| Popis: | The progression of chronic heart failure (CHF) is characterized by frequent exacerbation requiring hospitalization and high mortality. Clinical deterioration is triggered by many factors that could promote ongoing myocytes injury. We sought to determine whether a specific marker of cardiac injury, troponin T (cTnT), is associated with prognosis in acute decompensated heart failure (ADHF).One hundred and eighty-four consecutive patients with ADHF were enrolled in the absence of an acute coronary syndrome. A cTnT valueor =0.1 ng/ml in samples drawn at 6, 12 or 24 h after hospital admission was considered abnormal.Increased levels of cTnT were found in 58 patients (31.5%, group 1). There were no significant differences between group 1 and patients with cTnT0.1 ng/ml (group 2) in terms of demographic and clinical characteristics, although ischemic etiology was more prevalent in group 1 (51.7% vs. 31.7%, p=0.009). During follow-up, the mortality in groups 1 and 2 was 31% and 17.5% (p=0.038, OR=2.13, 95% CI: 1.03-4.69), respectively. The 3-year free-CHF readmission survival in group 1 and 2 was 25% and 53% (log rank test p=0.015). In a Cox proportional hazard model, poor tissue perfusion (HR=2.46, 95% CI=1.31-4.6), previous infarction (HR=1.99, 95% CI=1.02-3.9) and cTnTor =0.1 ng/ml (HR=1.74, 95% CI=1.05-2.9) emerged as the independent predictors of long-term outcome.One third of patients with decompensated CHF had elevated levels of cTnT. Troponin T was an independent long-term prognostic marker of morbidity and mortality and it suggests a role of biochemical risk stratification in this setting. |
| Databáze: | OpenAIRE |
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