Birgit Linnemann1, Thilo Sutter2, Eva Herrmann3, Sebastian Sixt2, Aljoscha Rastan2, Uwe Schwarzwaelder2, Elias Noory2, Karlheinz Buergelin2, Ulrich Beschorner2, Thomas Zeller2. 1. Department of Angiology, University Heart Center Bad Krozingen, Bad Krozingen, Germany; Division of Vascular Medicine, Department of Internal Medicine, Goethe University Hospital Frankfurt/Main, Frankfurt/Main, Germany. Electronic address: Birgit.Linnemann@kgu.de. 2. Department of Angiology, University Heart Center Bad Krozingen, Bad Krozingen, Germany. 3. Institute of Biostatistics and Math, Modeling, Faculty of Medicine, Goethe University Hospital Frankfurt/Main, Frankfurt/Main, Germany.
Abstract
OBJECTIVES: The aim of the present study was to evaluate whether elevated cardiac troponin T (cTnT) was independently associated with an increased all-cause mortality or risk of cardiovascular events and amputation among patients with peripheral arterial disease (PAD). BACKGROUND:PAD patients often have impaired renal function, and the blood concentration of cardiac troponin often increases with declining glomerular filtration rate. METHODS: The cohort consisted of 1,041 consecutive PAD patients (653 males, 388 females, age 70.7± 10.8 years, Rutherford stages 2 to 5) undergoing endovascular peripheral revascularization. RESULTS: At baseline, measurable cTnT levels (≥0.01 ng/ml) were detected in 21.3% of individuals. Compared with patients who had undetectable cTnT levels, those with cTnT levels ≥0.01 ng/ml had higher rates for mortality (31.7% vs. 3.9%, respectively; p < 0.001), myocardial infarction (4.1% vs. 1.1%, respectively; p = 0.003), and amputation (10.1% vs. 2.4%, respectively; p < 0.001) during a 1-year follow-up. In adjusted Cox regression models, cTnT levels ≥0.01 ng/ml were associated with increased total mortality (hazard ratio [HR]: 8.14; 95% confidence interval [CI]: 3.77 to 17.6; p < 0.001) and amputation rates (HR: 3.71; 95% CI: 1.33 to 10.3; p = 0.012). CONCLUSIONS: cTnT is frequently elevated in PAD patients and is associated with higher event rates in terms of total mortality and amputation. Even small cTnT elevations predict a markedly increased risk that is independent of an impaired renal function. (Troponin T as Risk Stratification Tool in Patients With Peripheral Arterial Occlusive Disease; NCT01087385).
RCT Entities:
OBJECTIVES: The aim of the present study was to evaluate whether elevated cardiac troponin T (cTnT) was independently associated with an increased all-cause mortality or risk of cardiovascular events and amputation among patients with peripheral arterial disease (PAD). BACKGROUND: PAD patients often have impaired renal function, and the blood concentration of cardiac troponin often increases with declining glomerular filtration rate. METHODS: The cohort consisted of 1,041 consecutive PAD patients (653 males, 388 females, age 70.7 ± 10.8 years, Rutherford stages 2 to 5) undergoing endovascular peripheral revascularization. RESULTS: At baseline, measurable cTnT levels (≥0.01 ng/ml) were detected in 21.3% of individuals. Compared with patients who had undetectable cTnT levels, those with cTnT levels ≥0.01 ng/ml had higher rates for mortality (31.7% vs. 3.9%, respectively; p < 0.001), myocardial infarction (4.1% vs. 1.1%, respectively; p = 0.003), and amputation (10.1% vs. 2.4%, respectively; p < 0.001) during a 1-year follow-up. In adjusted Cox regression models, cTnT levels ≥0.01 ng/ml were associated with increased total mortality (hazard ratio [HR]: 8.14; 95% confidence interval [CI]: 3.77 to 17.6; p < 0.001) and amputation rates (HR: 3.71; 95% CI: 1.33 to 10.3; p = 0.012). CONCLUSIONS:cTnT is frequently elevated in PAD patients and is associated with higher event rates in terms of total mortality and amputation. Even small cTnT elevations predict a markedly increased risk that is independent of an impaired renal function. (Troponin T as Risk Stratification Tool in Patients With Peripheral Arterial Occlusive Disease; NCT01087385).
Authors: Dharam J Kumbhani; Ph Gabriel Steg; Christopher P Cannon; Kim A Eagle; Sidney C Smith; Shinya Goto; E Magnus Ohman; Yedid Elbez; Piyamitr Sritara; Iris Baumgartner; Subhash Banerjee; Mark A Creager; Deepak L Bhatt Journal: Eur Heart J Date: 2014-02-28 Impact factor: 29.983
Authors: Kunihiro Matsushita; Lucia Kwak; Chao Yang; Yuanjie Pang; Shoshana H Ballew; Yingying Sang; Ron C Hoogeveen; Bernard G Jaar; Elizabeth Selvin; Christie M Ballantyne; A Richey Sharrett; Aaron R Folsom; Gerardo Heiss; Josef Coresh; Alan T Hirsch Journal: Eur Heart J Date: 2018-07-01 Impact factor: 35.855