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Prognostic role of highly sensitive cardiac troponin I in patients with systolic heart failure.
Am Heart J. 2010 Jan; 159(1):63-7.AH

Abstract

BACKGROUND

Cardiac troponin T (cTnT) and cardiac troponin I (cTnI) are useful biomarkers in patients with chronic heart failure (CHF). However, the clinical use has limitations due to the low sensitivity of a conventional commercial assay system. Recently, a high sensitive-cTnI (hs-cTnI) commercial assay has become available.

METHODS

To compare the prognostic value of cTnT and hs-cTnI, we measured hemodynamic parameters and serum levels of cTnT, hs-cTnI and N-terminal pro-brain natriuretic peptide (NT-proBNP)in 258 consecutive CHF patients and then followed these patients for a mean period of 2.6 years. In both assays of cTnT and hs-cTnI, the lowest concentration at which the coeffi cient of variation was < or =10% were 0.03 ng/mL, respectively. Therefore, in the present study, an elevated cTnT or cTnI test was defined as a level of > or =0.03 ng/mL.

RESULTS

During long-term follow up, there were 20 cardiac deaths. In 258 CHF patients, serum cTnT were elevated (> or =0.03 ng/mL) in 32 patients (12%) and serum hs-cTnI was elevated (> or =0.03 ng/mL) in 112 patients (43%). On stepwise multivariate analyses, high plasma NT-proBNP (> or =627 pg/mL, P = .0063) and hs-cTnI (> or =0.03 ng/mL) (P = .016) were independent significant prognostic predictors but cTnT (> or =0.03 ng/mL) was not. The hazard ratio for mortality of patients with high plasma NT-proBNP (> or =627 pg/mL) and hs-cTnI (> or =0.03 ng/mL) was 5.74 (95% CI, 2.33-14.28, P < .0001) compared to that of those with low NT-proBNP (<627 pg/mL) or hs-cTnI (<0.03 ng/mL).

CONCLUSIONS

These findings indicate that a high plasma concentration of hs-cTnI is an independent and useful prognostic predictor in patients with CHF.

Authors+Show Affiliations

Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan. tutamoto@belle.shiga-med.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

20102868

Citation

Tsutamoto, Takayoshi, et al. "Prognostic Role of Highly Sensitive Cardiac Troponin I in Patients With Systolic Heart Failure." American Heart Journal, vol. 159, no. 1, 2010, pp. 63-7.
Tsutamoto T, Kawahara C, Nishiyama K, et al. Prognostic role of highly sensitive cardiac troponin I in patients with systolic heart failure. Am Heart J. 2010;159(1):63-7.
Tsutamoto, T., Kawahara, C., Nishiyama, K., Yamaji, M., Fujii, M., Yamamoto, T., & Horie, M. (2010). Prognostic role of highly sensitive cardiac troponin I in patients with systolic heart failure. American Heart Journal, 159(1), 63-7. https://doi.org/10.1016/j.ahj.2009.10.022
Tsutamoto T, et al. Prognostic Role of Highly Sensitive Cardiac Troponin I in Patients With Systolic Heart Failure. Am Heart J. 2010;159(1):63-7. PubMed PMID: 20102868.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prognostic role of highly sensitive cardiac troponin I in patients with systolic heart failure. AU - Tsutamoto,Takayoshi, AU - Kawahara,Chiho, AU - Nishiyama,Keizo, AU - Yamaji,Masayuki, AU - Fujii,Masanori, AU - Yamamoto,Takashi, AU - Horie,Minoru, PY - 2009/08/22/received PY - 2009/10/16/accepted PY - 2010/1/28/entrez PY - 2010/1/28/pubmed PY - 2010/3/3/medline SP - 63 EP - 7 JF - American heart journal JO - Am Heart J VL - 159 IS - 1 N2 - BACKGROUND: Cardiac troponin T (cTnT) and cardiac troponin I (cTnI) are useful biomarkers in patients with chronic heart failure (CHF). However, the clinical use has limitations due to the low sensitivity of a conventional commercial assay system. Recently, a high sensitive-cTnI (hs-cTnI) commercial assay has become available. METHODS: To compare the prognostic value of cTnT and hs-cTnI, we measured hemodynamic parameters and serum levels of cTnT, hs-cTnI and N-terminal pro-brain natriuretic peptide (NT-proBNP)in 258 consecutive CHF patients and then followed these patients for a mean period of 2.6 years. In both assays of cTnT and hs-cTnI, the lowest concentration at which the coeffi cient of variation was < or =10% were 0.03 ng/mL, respectively. Therefore, in the present study, an elevated cTnT or cTnI test was defined as a level of > or =0.03 ng/mL. RESULTS: During long-term follow up, there were 20 cardiac deaths. In 258 CHF patients, serum cTnT were elevated (> or =0.03 ng/mL) in 32 patients (12%) and serum hs-cTnI was elevated (> or =0.03 ng/mL) in 112 patients (43%). On stepwise multivariate analyses, high plasma NT-proBNP (> or =627 pg/mL, P = .0063) and hs-cTnI (> or =0.03 ng/mL) (P = .016) were independent significant prognostic predictors but cTnT (> or =0.03 ng/mL) was not. The hazard ratio for mortality of patients with high plasma NT-proBNP (> or =627 pg/mL) and hs-cTnI (> or =0.03 ng/mL) was 5.74 (95% CI, 2.33-14.28, P < .0001) compared to that of those with low NT-proBNP (<627 pg/mL) or hs-cTnI (<0.03 ng/mL). CONCLUSIONS: These findings indicate that a high plasma concentration of hs-cTnI is an independent and useful prognostic predictor in patients with CHF. SN - 1097-6744 UR - https://www.unboundmedicine.com/medline/citation/20102868/Prognostic_role_of_highly_sensitive_cardiac_troponin_I_in_patients_with_systolic_heart_failure_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-8703(09)00819-9 DB - PRIME DP - Unbound Medicine ER -