| Popis: |
Hospitalization for heart failure (HHF) is a frequent manifestation of chronic heart failure (CHF), and represents the moment of greatest impact on costs and on risk for the patient, in particular after discharge. Contributing factors to this disappointingly high postdischarge event rate include the incomplete relief of fluid overload, insufficient patient education, the lack of implementation of evidence-based therapies, poor follow-up and inadequate risk stratification before leaving hospital. Among available tools, different biomarkers have been tested, including cardiac troponin (cTn). The value of cTn to monitoring and to stratifying risk before discharge has been evaluated by mean of three strategies: a single measurement before discharge, monitoring with serial sampling during hospitalization, and comparing admission and predischarge values to establishing the cTn "delta". Acute heart failure syndrome (AHFS) is an active and continuing process, which starts at admission, but its evolution might be unpredictable, and the prevention of ongoing myocardial damage (OMD) might be one of the important targets to improve prognosis. OMD is also a dynamic process and can be detected in CHF and HHF, at different moments and in diverse magnitudes, justifying the cTn monitoring. The favorable effect of drugs on cTn release and its association with better prognosis have increased our expectation for the role of serial determination in HHF patients. |
