Document Detail


Assessment of disease severity and outcome in patients with systemic light-chain amyloidosis by the high-sensitivity troponin T assay.
MedLine Citation:
PMID:  20581312     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cardiac biomarkers provide prognostic information in light-chain amyloidosis (AL). Thus, a novel high-sensitivity cardiac troponin T (hs-TnT) assay may improve risk stratification. hs-TnT was assessed in 163 patients. Blood levels were higher with cardiac than renal or other organ involvement and were related to the severity of cardiac involvement. Increased sensitivity was not associated with survival benefit. Forty-seven patients died during follow-up (22.3 ± 1.0 months). Nonsurvivors had higher hs-TnT than survivors. Outcome was worse if hs-TnT more than or equal to 50 ng/L and best less than 3 ng/L. Survival of patients with hs-TnT 3 to 14 ng/L did not differ from patients with moderately increased hs-TnT (14-50 ng/L), but was worse if interventricular septum was more than or equal to 15 mm. Discrimination according to the Mayo staging system was only achieved by the use of the hs-TnT assay, but not by the fourth-generation troponin T assay. Multivariate analysis revealed hs-TnT, NT-proBNP, and left ventricular impairment as independent risk factors for survival. hs-TnT and NT-proBNP predicted survival, even after exclusion of patients with impaired renal function. Plasma levels of the hs-TnT assay are associated with the clinical, morphologic, and functional severity of cardiac AL amyloidosis and could provide useful information for clinicians on cardiac involvement and outcome.
Authors:
Arnt V Kristen; Evangelos Giannitsis; Stephanie Lehrke; Ute Hegenbart; Matthias Konstandin; David Lindenmaier; Corina Merkle; Stefan Hardt; Philipp A Schnabel; Christoph Röcken; Stefan O Schonland; Anthony D Ho; Thomas J Dengler; Hugo A Katus
Publication Detail:
Type:  Journal Article     Date:  2010-06-25
Journal Detail:
Title:  Blood     Volume:  116     ISSN:  1528-0020     ISO Abbreviation:  Blood     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-08     Completed Date:  2010-11-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7603509     Medline TA:  Blood     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2455-61     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Angiology, and Respiratory Medicine, Heidelberg University, Heidelberg, Germany. Arnt_Kristen@med.uni-heidelberg.de
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MeSH Terms
Descriptor/Qualifier:
Amyloidosis / diagnosis*,  pathology
Female
Humans
Male
Middle Aged
Myocardium / pathology
Prognosis
Survival Analysis
Troponin T / blood,  diagnostic use*
Chemical
Reg. No./Substance:
0/Troponin T

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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