Highly sensitive troponin T for risk stratification of acutely destabilized heart failure

Pascual-Figal, Domingo A.; Casas, Teresa; Ordóñez-Llanos, Jordi; Manzano‐Fernández, Sergio; Bonaque, Juan C.; Boronat, M. Gómez; Muñoz‐Esparza, Carmen; Valdés, Mariano; Januzzi, James L.

doi:10.1016/j.ahj.2012.03.015

Cited by 79 publications

(46 citation statements)

References 17 publications

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“…Troponins are released into the circulation as an expression of myocardial necrosis and have been widely investigated in HF populations [3,4]. As in other series, elevated hscTn levels were almost constant in the population studied [5,6]. The progressive loss of myocytes in HF is greater during exacerbations due to increased capillary pulmonary pressure, lower coronary perfusion pressure, greater release of catecholamines, abnormal calcium metabolism, greater oxidative stress, and inflammation, etc.…”

Section: Discussionmentioning

confidence: 86%

High-sensitivity troponin is associated with high risk clinical profile and outcome in acute heart failure

Díez

Talavera²,

Conde

et al. 2016

Cardiol J.

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Background:The aim of the study was to evaluate the value of high-sensitivity cardiac troponin (hs-cTn) ng/L); median hs-cTn was 42 ng/L (IQR 24-81). Patients with ejection fraction (EF) ≤ 45% had higher hs-cTn values (p = 0.0004). Patients with low cardiac output syndrome (LCOS) or shock had higher troponin levels compared with those with less severe clinical presentations (p = 0.004). Patients who required inotropic presented higher troponin values (p = 0.002), troponin values were also higher in those requiring complex therapies (intra-aortic balloon pump, mechanical ventilation or hemodialysis, p = 0.002). At 90-day follow-up, 28 (15.5%) patients died and 27 rehospitalizations occurred (55 events). The risk of events was greater in patients with hs-cTn > 42 ng/L (0.021), low blood pressure at admission (p = 0.002), LCOS or shock (p < 0.0001), EF ≤ 45% (p = 0.005) and inotropic use (p < 0.0001). In multivariate analysis, only inotropic agents requirements was associated independently with a high risk of death or rehospitalizations at 90 days (p = 0.007).Conclusions: Elevation of hs-cTn is a finding almost constant in patients with decompensated HF. In subjects with higher troponin levels ventricular dysfunction is frequent. The use of hs-cTn for risk stratification at admission helps to identify populations with poor outcome during hospitalization and increased risk of death or rehospitalizations during follow-up who will require rapid implementation of aggressive treatment. (Cardiol J 2016; 23, 1: 78-83)

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Section: Discussionmentioning

confidence: 86%

High-sensitivity troponin is associated with high risk clinical profile and outcome in acute heart failure

Díez

Talavera²,

Conde

et al. 2016

Cardiol J.

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“…cardiomyocyte injury, indicating it is more common than previously thought and not restricted to acute cardiac conditions. The phenomenon of hemodynamic cardiac stress induced cardiomyocyte injury has first been described in patients with acute heart failure [11,12]. We can only hypothesize why increased hemodynamic cardiac stress leads to a predominate release of cTnT and I, as assessed by sensitive assays, and Myoglobin rather than CK-MB.…”

Section: Resultsmentioning

confidence: 97%

Cardiomyocyte injury induced by hemodynamic cardiac stress: Differential release of cardiac biomarkers

Irfan

Reichlin

Twerenbold

et al. 2015

Clinical Biochemistry

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“…In a study of 202 patients with AHF, conventional cTnT and hsTnT assays were performed and patients were followed-up for >1 year for mortality. 37 Both cTnT and hsTnT had predictive value for death. In patients with a cTnT level <0.03 ng/ml, the addition of a positive hsTnT value, especially if greater than 20 pg/ml, improved risk prediction of death over clinical factors alone.…”

Section: Prognostic Value Of Hstnmentioning

confidence: 99%

Role of Cardiac Troponin Levels in Acute Heart Failure

Wettersten

Maisel

2015

Cardiac Failure Review

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Cardiac troponin (cTn) is the primary biomarker for the diagnosis of myocardial necrosis in an acute coronary syndrome (ACS). cTn levels can also be elevated in many other conditions, including heart failure, with significant prognostic value. An elevated cTn level can be found in both acute and chronic heart failure and its presence is believed to be due to multiple different pathophysiological processes. In acute decompensated heart failure (AHF), an elevated cTn level has been repeatedly shown to correlate with increased short- and long-term mortality and, to a lesser extent, readmission rates. These associations have been demonstrated with both I and T isoforms of cTn, as well as when troponin is measured with conventional assays or new high-sense assays. In multimarker models, cTn has repeatedly been found to be an independent predictive variable enhancing prognostic ability of the model. cTn is therefore an important biomarker for prognosis in AHF.

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Highly sensitive troponin T for risk stratification of acutely destabilized heart failure

Cited by 79 publications

References 17 publications

High-sensitivity troponin is associated with high risk clinical profile and outcome in acute heart failure

High-sensitivity troponin is associated with high risk clinical profile and outcome in acute heart failure

Cardiomyocyte injury induced by hemodynamic cardiac stress: Differential release of cardiac biomarkers

Role of Cardiac Troponin Levels in Acute Heart Failure

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