Prediction of Outcome by Highly Sensitive Troponin T in Outpatients With Chronic Systolic Left Ventricular Heart Failure

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• 作者：Michael Egstrup ; Morten Schou ; Christian D. Tuxen ; Caroline N. Kistorp ; Per R. Hildebr ; t ; Finn Gustafsson ; Jens Faber ; Jens-Peter Goetze ; Ida Gustafsson
• 刊名：The American Journal of Cardiology
• 出版年：2012
• 出版时间：15 August, 2012
• 年：2012
• 卷：110
• 期：4
• 页码：552-557
• 全文大小：356 K

文摘

Our aim was to assess the prognostic impact of a high-sensitivity cardiac troponin T (hs-cTnT) assay in an outpatient population with chronic systolic left ventricular heart failure (HF). Four hundred sixteen patients with chronic HF and left ventricular ejection fraction ¡Ü45 % were enrolled in a prospective cohort study. In addition to hs-cTnT, plasma amino-terminal pro-B-type natriuretic peptide was measured at baseline. Mean age was 71 years, 29 % were women, 62 % had coronary artery disease (CAD), mean left ventricular ejection fraction was 31 % , and 57 % had abnormal level of hs-cTnT. During 4.4 years of follow-up, 211 (51 % ) patients died. In multivariate Cox regression models, hs-cTnT was categorized as quartiles or dichotomized by the 99th percentile of a healthy population. Adjusted hazard ratios for all-cause mortality for quartiles 2 to 4, with quartile 1 as reference, were 1.4 (95 % confidence interval 0.9 to 2.4, p = 0.16) for quartile 2, 1.7 (0.9 to 2.5, p = 0.12) for quartile 3, and 2.6 (1.6 to 4.4, p <0.001) for quartile 4 and 1.7 (1.2 to 2.5, p = 0.003) for abnormal versus normal level of hs-cTnT. In patients without CAD, quartile 4 of hs-cTnT was associated with an adjusted hazard ratio of 6.8. In conclusion, hs-cTnT is increased in most outpatients with chronic systolic HF and carries prognostic information beyond clinical parameters and amino-terminal pro-B-type natriuretic peptide. Increased hs-cTnT indicated a particularly deleterious prognosis in patients without CAD.