Serial measurements of high sensitive cardiac troponin I in patients with acutely decompensated heart failure treated with carperitide or nitrates.
BACKGROUND
In patients with acutely decompensated heart failure (ADHF), elevated serum concentration of cardiac troponin is an independent predictor of adverse cardiac events. In ADHF with a preserved systolic blood pressure, treatment with intravenous vasodilator is recommended. However, the effect of vasodilators on troponin concentrations has not been elucidated well.


RESULTS
Serial high sensitive cardiac troponin I (hs-TnI) was measured in 36 patients presenting with ADHF and preserved systolic blood pressure, of whom 20 were treated with atrial natriuretic peptide (ANP) and 16 with nitrates. The concentrations of hs-TnI ranged from 0.069+/-0.114ng/ml at baseline to 0.076+/-0.121ng/ml at 5h, 0.062+/-0.106ng/ml at 1 day, and 0.056+/-0.089ng/ml at day 7 (n=36,ns). The relative change in hs-TnI between baseline and at 5h, day 1 and day 7 were 1.13+/-0.43, 0.95+/-0.44 and 0.93+/-0.64 in patients treated with ANP, and 1.02+/-0.19, 0.95+/-0.31 and 1.19+/-1.38 in patients treated with nitrates (ns; ANP versus nitrates). On day 7, a hs-TnI change, >20% decrease from baseline, was observed in 55% patients with ANP versus 56% patients with nitrates (ns). The cardiac event rates were similar in both groups.


CONCLUSIONS
In ADHF patients with preserved systolic blood pressure, the administration of intravenous vasodilators did not decrease hs-TnI over the first 7 days. Treatments with ANP and nitrates were associated with similar short-term decreases in hs-TnI and long-term adverse cardiac events.
Sato
Yukihito
Y
Department of Cardiology, Hyogo Prefectural Amagasaki Hospital, Higashidaimotsucho 1-1-1, Amagasaki, Hyogo 660-0828, Japan. cardioys@kuhp.kyoto-u.ac.jp
Nishi
Kiyoto
K
Saijo
Sayaka
S
Tanada
Yohei
Y
Goto
Taisuke
T
Takahashi
Naoki
N
Yamamoto
Erika
E
Fukuhara
Rei
R
Miyamoto
Tadashi
T
Taniguchi
Ryoji
R
Fujiwara
Hisayoshi
H
Takatsu
Yoshiki
Y
D000368:Aged; D009320:Atrial Natriuretic Factor / Q000097:blood / Q000627:therapeutic use*; D001794:Blood Pressure; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D008297:Male; D009566:Nitrates / Q000627:therapeutic use*; D019210:Troponin I / Q000097:blood*; D014665:Vasodilator Agents / Q000627:therapeutic use*
C472955:NPPA protein, human; D009566:Nitrates; D019210:Troponin I; D014665:Vasodilator Agents; D009320:Atrial Natriuretic Factor