- 作者：Toru Kubo ; Hiroaki Kitaoka ; Shigeo Yamanaka ; Takayoshi Hirota ; Yuichi Baba ; Kayo Hayashi ; Tatsuo Iiyama ; Naoko Kumagai ; Katsutoshi Tanioka ; Naohito Yamasaki ; Yoshihisa Matsumura ; Takashi Furuno ; Tetsuro Sugiura ; Yoshinori L. Doi
- 关键词：biomarker ; high-sensitivity cardiac troponin T ; hypertrophic cardiomyopathy ; prognosis
- 刊名：Journal of the American College of Cardiology
- 出版年：2013
- 出版时间：1 October, 2013
- 年：2013
- 卷：62
- 期：14
- 页码：1252-1259
- 全文大小：774 K
Objectives
This study investigated the significance of the serum high-sensitivity cardiac troponin T (hs-cTnT) marker for prediction of adverse events in hypertrophic cardiomyopathy (HCM).Background
Although serum cardiac troponins as sensitive and specific markers of myocardial injury have become well-established diagnostic and prognostic markers in acute coronary syndrome, the usefulness of hs-cTnT for prediction of cardiovascular events in patients with HCM is unclear.
Methods
We performed clinical evaluation, including measurements of hs-cTnT in 183 consecutive patients with HCM.
Results
Of 183 HCM patients, 99 (54 % ) showed abnormal hs-cTnT values (>0.014 ng/ml). During a mean follow-up of 4.1 ¡À 2.0 years, 32 (32 % ) of the 99 patients in the abnormal hs-cTnT group, but only 6 (7 % ) of 84 patients with?normal hs-cTnT values, experienced cardiovascular events: cardiovascular deaths, unplanned heart failure admissions, sustained ventricular tachycardia, embolic events, and progression to New York Heart Association functional class III or IV status (hazard ratio [HR]: 5.05, p?< 0.001). Abnormal hs-cTnT value remained an independent predictor of these cardiovascular events after multivariate analysis (HR: 3.23, p?= 0.012). Furthermore, in the abnormal hs-cTnT group, overall risk increased with an increase in hs-cTnT value (HR: 1.89/hs-cTnT 1 SD increase in the logarithmic scale, 95 % confidence interval: 1.13 to 3.15; p?= 0.015 [SD: 0.59]).
Conclusions
In patients with HCM, an abnormal serum concentration of hs-cTnT is an independent predictor of adverse outcome, and a higher degree of abnormality in hs-cTnT value is associated with a greater risk of cardiovascular events.