BACKGROUND: Elevated cardiac troponin (cTn) levels are relatively common in acute heart failure (AHF). AIMS: To evaluate the prevalence and prognostic significance of elevated cTnI and cTnT in AHF. METHODS: FINN-AKVA is a prospective, multicenter study in AHF. In this analysis, 364 non-ACS patients with measurements of cTnI and cTnT taken on admission and 48 h thereafter were analyzed. RESULTS: Of the 364 AHF patients, 51.1% had cTnI and 29.7% cTnT levels above the cut-off value. Six-month all-cause mortality was 18.7%. Both cTnI (OR 2.0, 95% CI 1.2-3.5, p=0.01) and cTnT (OR 2.6, 95% CI 1.5-4.4, p=0.0006) were associated with adverse outcome. The mortality risk was proportional to the magnitude of cTn release. On multivariable analysis, Cystatin C (OR 6.3, 95% CI 3.2-13, p<0.0001), logNT-proBNP (OR 1.4, 95% CI 1.0-1.8, p=0.03) and systolic blood pressure on admission (/10 mm Hg increase, OR 0.9, 95% CI 0.8-0.9, p=0.0004) were independent risk markers, whereas the troponins were not significantly associated with increased mortality. CONCLUSIONS: cTn elevations are frequent in AHF patients without ACS. cTnI is more often elevated than cTnT. Both cTnI and cTnT elevations are associated with increased mortality proportional to the degree elevation but they do not act as independent risk markers.
BACKGROUND: Elevated cardiac troponin (cTn) levels are relatively common in acute heart failure (AHF). AIMS: To evaluate the prevalence and prognostic significance of elevated cTnI and cTnT in AHF. METHODS:FINN-AKVA is a prospective, multicenter study in AHF. In this analysis, 364 non-ACS patients with measurements of cTnI and cTnT taken on admission and 48 h thereafter were analyzed. RESULTS: Of the 364 AHF patients, 51.1% had cTnI and 29.7% cTnT levels above the cut-off value. Six-month all-cause mortality was 18.7%. Both cTnI (OR 2.0, 95% CI 1.2-3.5, p=0.01) and cTnT (OR 2.6, 95% CI 1.5-4.4, p=0.0006) were associated with adverse outcome. The mortality risk was proportional to the magnitude of cTn release. On multivariable analysis, Cystatin C (OR 6.3, 95% CI 3.2-13, p<0.0001), logNT-proBNP (OR 1.4, 95% CI 1.0-1.8, p=0.03) and systolic blood pressure on admission (/10 mm Hg increase, OR 0.9, 95% CI 0.8-0.9, p=0.0004) were independent risk markers, whereas the troponins were not significantly associated with increased mortality. CONCLUSIONS:cTn elevations are frequent in AHF patients without ACS. cTnI is more often elevated than cTnT. Both cTnI and cTnT elevations are associated with increased mortality proportional to the degree elevation but they do not act as independent risk markers.
Authors: Marco Metra; Luca Bettari; Franca Pagani; Valentina Lazzarini; Carlo Lombardi; Valentina Carubelli; Graziella Bonetti; Silvia Bugatti; Giovanni Parrinello; Luigi Caimi; G Michael Felker; Livio Dei Cas Journal: Clin Res Cardiol Date: 2012-03-10 Impact factor: 5.460
Authors: Yaser Cheema; Jonathan N Sherrod; Wenyuan Zhao; Tieqiang Zhao; Robert A Ahokas; Yao Sun; Ivan C Gerling; Syamal K Bhattacharya; Karl T Weber Journal: J Cardiovasc Pharmacol Date: 2011-07 Impact factor: 3.105
Authors: Malay S Gandhi; German Kamalov; Atta U Shahbaz; Syamal K Bhattacharya; Robert A Ahokas; Yao Sun; Ivan C Gerling; Karl T Weber Journal: Heart Fail Rev Date: 2011-01 Impact factor: 4.214
Authors: Brian J Borkowski; Yaser Cheema; Atta U Shahbaz; Syamal K Bhattacharya; Karl T Weber Journal: Eur Heart J Date: 2011-03-12 Impact factor: 29.983
Authors: Michael R Seawell; Fahed Al Darazi; Victor Farah; Kodangudi B Ramanathan; Kevin P Newman; Syamal K Bhattacharya; Karl T Weber Journal: Curr Heart Fail Rep Date: 2013-03