Document Detail


Troponin I in acute decompensated heart failure: insights from the ASCEND-HF study.
MedLine Citation:
PMID:  22764184     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
AIMS: We examined the prognostic importance of cardiac troponin I (cTnI) in a cohort of patients enrolled in the ASCEND-HF study of nesiritide in acute decompensated heart failure (ADHF). Circulating troponins are a prognostic marker in patients with ADHF. Contemporary assays with greater sensitivity require reassessment of the significance of troponin elevation in HF. METHODS AND RESULTS: Cardiac troponin I was measured in a core laboratory in 808 ADHF patients enrolled in the ASCEND-HF biomarkers substudy using a sensitive assay (VITROS Trop I ES, Ortho Clinical Diagnostics) with a lower limit of detection of 0.012 ng/mL and a 99th percentile upper reference limit (URL) of 0.034 ng/mL. Patients with clinical evidence of acute coronary syndrome or troponin >5× the URL were excluded. Multivariable modelling was used to assess the relationship between log(cTnI) and in-hospital and post-discharge outcomes. Baseline cTnI was undetectable in 22% and elevated above the 99th percentile URL in 50% of subjects. cTnI levels did not differ based on HF aetiology. After multivariable adjustment, higher cTnI was associated with worsened in-hospital outcomes such as length of stay (P = 0.01) and worsening HF during the index hospitalization (P = 0.01), but was not associated with worsened post-discharge outcomes at 30 or 180 days. The relationship between cTnI and outcomes was generally linear and there was no evidence of a threshold effect at any particular level of cTnI. CONCLUSION: cTnI is elevated above the 99th percentile URL in 50% of ADHF patients and predicts in-hospital outcome, but is not an independent predictor of long-term outcomes.
Authors:
G Michael Felker; Vic Hasselblad; W H Wilson Tang; Adrian F Hernandez; Paul W Armstrong; Gregg C Fonarow; Adriaan A Voors; Marco Metra; John J V McMurray; Javed Butler; Gretchen M Heizer; Kenneth Dickstein; Barry M Massie; Dan Atar; Richard W Troughton; Stefan D Anker; Robert M Califf; Randall C Starling; Christopher M O'Connor
Related Documents :
22064334 - Metabolic syndrome frequency in inflammatory bowel diseases.
15857334 - Clinical assessment alone will not benefit patients with coronary heart disease: failur...
19770794 - Switching from atorvastatin to simvastatin in patients at high cardiovascular risk: eff...
22570774 - Persistent sepsis-induced hypotension without hyperlactatemia: a distinct clinical and ...
17564 - Jejunal mucosal gamma glutamyl transferase activity in coeliac disease.
22964554 - Diagnostic yield of capsule endoscopy in refractory celiac disease.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-4
Journal Detail:
Title:  European journal of heart failure     Volume:  -     ISSN:  1879-0844     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100887595     Medline TA:  Eur J Heart Fail     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Duke Clinical Research Institute, Duke University Medical Center, Durham, NC 27705, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

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


Previous Document:  Effect of nebivolol on outcome in elderly patients with heart failure and atrial fibrillation: insig...
Next Document:  High leptin and resistin expression in chronic heart failure: adverse outcome in patients with dilat...