title: Cardiac troponin T as a prognostic marker in patients with heart failure : a 3-year outcome study.
abstract: Cardiac troponin T (cTnT), a highly sensitive and specific indicator of myocardial cell death, may be elevated in congestive heart failure (CHF). The aims of this study were to test the hypothesis that decompensated CHF may be associated with an increase in cTnT release and to correlate between cTnT levels and patient outcomes. The authors studied 55 patients aged between 38 and 86 years (30 women and 25 men) who were hospitalized for CHF. Left ventricular ejection fraction (EF) was calculated by using modified Simpson's rule by echocardiography. cTnT levels were assessed. Troponin T >or=0.1 ng/mL was considered as positive. All patients were contacted by phone annually during the next 3 years, and their history of subsequent hospital admissions and current health status were recorded. cTnT was negative in 44 (80%) and positive in 11 (20%) patients. EF was significantly lower and NYHA was higher in cTnT-positive patients. During the 3-year follow-up period, 25 patients died from CHF. The mortality rate was 8/11 (72.7%) among cTnT-positive patients, whereas the mortality rate was 17/44 (38.6%) among cTnT-negative patients. There were significant relationships among positivity of cTnT, NYHA, EF, and mortality rate. Multivariate regression analysis yielded an independent relationship between positivity of cTnT, NYHA classification, and mortality rate. The percent of hospital admissions due to CHF was also higher in patients with cTnT positive (63.6% versus, 27.3%, p <0.05). In conclusion, this study shows that cTnT positivity is an independent risk factor in predicting the long-term mortality and morbidity rate in patients with CHF. Patients with worsening CHF may possibly be identified early on the basis of their elevated serum cTnT levels.
authors.affiliation: Department of Cardiology, Cukurova University, School of Medicine, Adana, Turkey. mdemir@cu.edu.tr
authors.forename: Mesut
authors.initials: M
authors.lastname: Demir
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kanadasi
authors.forename: Onur
authors.initials: O
authors.lastname: Akpinar
authors.forename: Yurdaer
authors.initials: Y
authors.lastname: Dönmez
authors.forename: Mahir
authors.initials: M
authors.lastname: Avkarogullari
authors.forename: Cumhur
authors.initials: C
authors.lastname: Alhan
authors.forename: Tamer
authors.initials: T
authors.lastname: Inal
authors.forename: Mustafa
authors.initials: M
authors.lastname: San
authors.forename: Ayhan
authors.initials: A
authors.lastname: Usal
authors.forename: Mustafa
authors.initials: M
authors.lastname: Demirtas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012720:Severity of Illness Index; D013318:Stroke Volume; D013997:Time Factors; D020107:Troponin T / Q000097:blood*; D015854:Up-Regulation; D016277:Ventricular Function, Left
chemical_list: D015415:Biomarkers; D020107:Troponin T