Prognostic value of cardiac troponin T elevation is independent of renal function and clinical findings in heart failure patients.
BACKGROUND
The aim of this study is to determine the prevalence and prognostic value of elevated cardiac troponin (cTnT) and its association with clinical characteristics according to renal function status in patients with stable heart failure.


METHODS
In a prospective observational study, 152 consecutive patients from the Heart Failure Clinic of the INCMNSZ were followed for a period of 42 months. All underwent clinical evaluation, echocardiography, and determination of body composition by electric bioimpedance to identify hypervolemia. Concentrations of cTnT were quantified by immunoassay with electrochemoluminescence and > or = 0.02 ng/mL levels were considered elevated. Also glomerular filtration rate (eGFR) was estimated using the Cockcroft-Gault equation.


RESULTS
Elevated cTnT was significantly associated with increased all-cause mortality in the observational period even after adjusting for eGFR < 60 mL/min/1.73 m2 and clinical findings such as hypertension, functional class, loop diuretics, angiotensin converting enzyme inhibitors, pulmonary pressure and hypervolemia in Cox regression analysis with a hazard ratio of 4.58 (95% confidence interval: 1.84-11.45).


CONCLUSIONS
Heart failure patients with elevated cardiac-specific troponin T are at increased risk of death independently of the presence of chronic kidney disease.
Orea-Tejeda
Arturo
A
Heart Failure Clinic, Mexico City, México.
Sánchez-González
Luis R
LR
Castillo-Martínez
Lilia
L
Valdespino-Trejo
Adrian
A
Sánchez-Santillán
Rocío N
RN
Keirns-Davies
Candace
C
Colín-Ramírez
Eloisa
E
Montańo-Hernández
Patricia
P
Dorantes-García
Joel
J
D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001810:Blood Volume; D055664:Electrochemical Techniques; D005260:Female; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000150:complications / Q000401:mortality / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D007118:Immunoassay; D007668:Kidney / Q000503:physiopathology*; D008163:Luminescent Measurements; D008168:Lung / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism*; D011237:Predictive Value of Tests; D011312:Pressure; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D049994:Sodium Potassium Chloride Symporter Inhibitors / Q000627:therapeutic use; D020107:Troponin T / Q000097:blood*
D000806:Angiotensin-Converting Enzyme Inhibitors; D049994:Sodium Potassium Chloride Symporter Inhibitors; D020107:Troponin T