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Published in: Clinical Research in Cardiology 8/2012

01-08-2012 | Original Paper

Troponin T levels in patients with acute heart failure: clinical and prognostic significance of their detection and release during hospitalisation

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

Published in: Clinical Research in Cardiology | Issue 8/2012

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Abstract

Aims

Myocardial injury during an episode of acute heart failure (AHF) may be important for patents’ outcome. We hypothesised that an increase of cardiac troponin levels (cTnT) during hospitalisation, in patients with undetectable levels on admission (cTnT release), may be a more specific marker of myocardial damage. With this aim, we assessed the clinical and prognostic significance of high serum cTnT levels at the time of admission and that of cTnT release in 198 consecutive patients admitted for AHF and with no signs of acute coronary syndrome.

Methods and results

cTnT levels were serially measured at the time of admission, and after 6 and 12 h, in 198 consecutive patients admitted for AHF and with no signs of acute coronary syndrome. cTnT was detectable (>0.01 ng/mL) in 102 patients (52 %) and positive for myocardial necrosis (>0.03 ng/mL) in 78 patients (39 %). Negative cTnT at the time of admission became positive at 6 and/or 12 h in 36 (18 %) patients. Patients with increased cTnT levels were more likely to have coronary artery disease, hypertension, diabetes, and renal dysfunction. During a median follow-up duration of 247 days (IQR 96–480 days), the detection of increased cTnT levels was associated with a higher rate of all-cause deaths and, for cTnT release, all-cause death and cardiovascular rehospitalisation rate. CTnT release was an independent predictor of all-cause death and cardiovascular rehospitalisation, along with glomerular filtration rate, and the administration of inotropic agents during the initial hospitalisation.

Conclusions

Increased cTnT levels are a frequent finding in patients with AHF. They are more likely to occur in patients with comorbidities and are associated with poorer outcomes. cTnT release is an independent predictor of poorer outcomes.
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Metadata
Title
Troponin T levels in patients with acute heart failure: clinical and prognostic significance of their detection and release during hospitalisation
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
Publication date
01-08-2012
Publisher
Springer-Verlag
Published in
Clinical Research in Cardiology / Issue 8/2012
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI
https://doi.org/10.1007/s00392-012-0441-5

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