Prognostic value of cardiac troponin T in patients with both acute and chronic stable congestive heart failure: comparison with atrial natriuretic peptide, brain natriuretic peptide and plasma norepinephrine.
BACKGROUND
The prognostic value of cardiac troponin T (cTn-T) in a mixture of patients with both acute and chronic congestive heart failure (CHF), simultaneously assessed and compared with neurohormonal factors, has not yet been thoroughly evaluated. Thus, we focused on the prognostic value of cTn-T in comparison with atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP) and plasma norepinephrine (PNE) in this population.


METHODS
Prognostic correlates of elevation of cTn-T, ANP, BNP, PNE were analyzed in 63 acute and chronic CHF patients followed up to record worsening CHF and cardiac death.


RESULTS
cTn-T (> or =0.03 microg/L) was found in 17.4% (11 of 63) of patients. cTn-T correlated with ANP, BNP, PNE. Acute CHF patients were more positive for cTn-T and BNP. In our cohort, neither cTn-T (> or =0.03 microg/L) nor PNE were associated with increased mortality and worsening HF in CHF patients. After adjustment, BNP was the only independent predictor of cardiac events (RR, 3.23; p=0.01).


CONCLUSIONS
BNP emerged as the only independent predictor of cardiac events in a mixture of patients with both acute and chronic CHF, suggesting that it is the analyte that best reflects long-term prognosis in a diverse population enrolled to mirror the "real world" situation.
Bertinchant
Jean-Pierre
JP
Department of Cardiology, University Hospital, Place Professeur Robert Debré, 30029 Nîmes Cedex 9, France. jean.pierre.bertinchant@chu-nimes.fr
Combes
Nicolas
N
Polge
Anne
A
Fabbro-Peray
Pascale
P
Raczka
Franck
F
Beck
Lionel
L
Cade
Stéphane
S
Ledermann
Bertrand
B
D000208:Acute Disease; D000328:Adult; D000368:Aged; D009320:Atrial Natriuretic Factor / Q000378:metabolism*; D002908:Chronic Disease; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis* / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000378:metabolism*; D009638:Norepinephrine / Q000097:blood*; D011237:Predictive Value of Tests; D011379:Prognosis; D020107:Troponin T / Q000378:metabolism*
D020107:Troponin T; D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor; D009638:Norepinephrine