title: High-sensitivity troponin T is associated with poor outcome in adults with pulmonary arterial hypertension due to congenital heart disease.
abstract: OBJECTIVE
  Pulmonary arterial hypertension due to congenital heart disease (CHD-PAH) has a poor prognosis. We sought to determine whether the biomarker high-sensitivity troponin T (hsTnT) measured on routine visit at the outpatient clinic is associated with prognosis.
  
  
  METHODS
  Consecutive adult CHD-PAH (86% Eisenmenger syndrome) patients referred for advanced medical therapy between January 2005 and March 2007 in the Academic Medical Center in Amsterdam. Patients with severe renal impairment were excluded.
  
  
  METHODS
  The primary outcome was mortality.
  
  
  RESULTS
  Of all 31 patients (mean age 45 ± 12 years) with CHD-PAH, eight patients died during a median follow-up of 5.6 (range 1.6 to 6.8) years. A hsTnT level >0.014 μg/L was the 99th percentile cutoff of the normal distribution and therefore defined as elevated. At baseline, elevated levels of hsTnT were found in eight patients (26%). In univariate Cox regression, hsTnT elevated at baseline, NT-pro-BNP and right ventricular function were determinants of death (P < .05 for all). Patients with elevated levels of hsTnT showed a significantly higher mortality rate as compared to patients with normal hsTnT levels (62% vs. 13%, P = .005).
  
  
  CONCLUSIONS
  Levels of hsTnT were abnormal in a substantial proportion of CHD-PAH patients. A significant inverse relationship was found between hsTnT and survival.
authors.affiliation: Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands; Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Schuuring
authors.forename: Annelieke C M J
authors.initials: AC
authors.lastname: van Riel
authors.forename: Jeroen C
authors.initials: JC
authors.lastname: Vis
authors.forename: Marielle G
authors.initials: MG
authors.lastname: Duffels
authors.forename: Jan P
authors.initials: JP
authors.lastname: van Straalen
authors.forename: S Matthijs
authors.initials: SM
authors.lastname: Boekholdt
authors.forename: Jan G P
authors.initials: JG
authors.lastname: Tijssen
authors.forename: Barbara J M
authors.initials: BJ
authors.lastname: Mulder
authors.forename: Berto J
authors.initials: BJ
authors.lastname: Bouma
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D004541:Eisenmenger Complex / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology; D065627:Familial Primary Pulmonary Hypertension; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D009426:Netherlands; D010446:Peptide Fragments / Q000097:blood; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D013997:Time Factors; D020107:Troponin T / Q000097:blood*; D015854:Up-Regulation; D016278:Ventricular Function, Right
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D020107:Troponin T; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain