Javier Jacob1, Alex Roset1, Òscar Miró2, Aitor Alquézar3, Pablo Herrero4, Francisco Javier Martín-Sanchez5, Martin Möckel6, Christian Müller7, Pere Llorens8. 1. a Emergency Department , Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat , Barcelona , Catalonia , Spain. 2. b Emergency Department , Hospital Clínic, Research Group "Emergencies: processes and diseases", IDIBAPS , Barcelona , Catalonia , Spain. 3. c Emergency Department , Hospital de la Santa Creu i Sant Pau , Barcelona , Catalonia , Spain. 4. d Emergency Department , Hospital Universitario Central de Asturias , Oviedo , Spain. 5. e Emergency Department , Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC) , Madrid , Spain. 6. f Department of Cardiology Division of Emergency Medicine , Charité-University Medicine Berlin , Berlin , Germany. 7. g Department of Cardiology & Cardiovascular Research Institute Basel , University Hospital Basel , Basel , Switzerland. 8. h Department of Emergency Medicine, Short-Stay Unit and Hospital at-home , Hospital General Universitario de Alicante , Alicante , Spain.
Abstract
OBJECTIVE: Evaluate the use of different cardiac troponin (cTn) immunoassays and the prognostic value of increased cTn values in patients diagnosed with acute heart failure (AHF) in the emergency department (ED). METHOD: The epidemiology acute heart failure emergency-TROPonin in acute heart failure2 (EAHFE-TROPICA2) is a retrospective study including patients with AHF admitted in 34 Spanish EDs with cTn values determined in the ED. We studied the prevalence of elevated troponin (value above the established reference limit) for the different types of troponin. We also assessed crude and adjusted primary (1-year all-cause death) and secondary (30 d ED revisit due to AHF) outcomes for every type of cTn and different magnitudes of troponin elevation. RESULTS: We analysed 4705 episodes of AHF. Troponin was elevated in 48.4% of the cases (25.3% in cTnI, 37.9% in cTnT and 82.2% in hs-cTnT). Mortality at one year was higher in patients with elevated troponin (adjusted HR 1.61; CI 95% 1.38-1.88) regardless of the type of cTn determined. Elevated troponin was not related to ED revisit within 30 d after discharge (1.01; 0.87-1.19). CONCLUSIONS: The use of conventional troponin in the ED is useful to predict one-year mortality in patients with AHF. Highly sensitive cTnT (hs-cTnT) elevations less than double the reference value have no impact on patient outcome.
OBJECTIVE: Evaluate the use of different cardiac troponin (cTn) immunoassays and the prognostic value of increased cTn values in patients diagnosed with acute heart failure (AHF) in the emergency department (ED). METHOD: The epidemiology acute heart failure emergency-TROPonin in acute heart failure2 (EAHFE-TROPICA2) is a retrospective study including patients with AHF admitted in 34 Spanish EDs with cTn values determined in the ED. We studied the prevalence of elevated troponin (value above the established reference limit) for the different types of troponin. We also assessed crude and adjusted primary (1-year all-cause death) and secondary (30 d ED revisit due to AHF) outcomes for every type of cTn and different magnitudes of troponin elevation. RESULTS: We analysed 4705 episodes of AHF. Troponin was elevated in 48.4% of the cases (25.3% in cTnI, 37.9% in cTnT and 82.2% in hs-cTnT). Mortality at one year was higher in patients with elevated troponin (adjusted HR 1.61; CI 95% 1.38-1.88) regardless of the type of cTn determined. Elevated troponin was not related to ED revisit within 30 d after discharge (1.01; 0.87-1.19). CONCLUSIONS: The use of conventional troponin in the ED is useful to predict one-year mortality in patients with AHF. Highly sensitive cTnT (hs-cTnT) elevations less than double the reference value have no impact on patient outcome.
Authors: Maribel González-Del-Hoyo; Germán Cediel; Anna Carrasquer; Gil Bonet; Karla Vásquez-Nuñez; Carme Boqué; Samuel Alí; Alfredo Bardají Journal: Clin Cardiol Date: 2019-03-26 Impact factor: 2.882
Authors: Jakob Ledwoch; Anna Krauth; Jana Kraxenberger; Alisa Schneider; Katharina Leidgschwendner; Vera Schneider; Alexander Müller; Karl-Ludwig Laugwitz; Christian Kupatt; Eimo Martens Journal: Heart Vessels Date: 2021-06-21 Impact factor: 2.037