title: Troponin T in acute heart failure: clinical implications and prognosis in the Spanish National Registry on Heart Failure.
abstract: BACKGROUND
  Elevated troponin in heart failure has been associated with worse prognosis, but there are differences in the design and results of published studies. Our objective was to determine the association of troponin T with mortality and readmissions in patients with acute heart failure in clinical practice conditions.
  
  
  METHODS
  We included patients from the RICA registry who were hospitalized for acute heart failure. They were classified into 3 groups according to troponin T levels: normal, intermediate and high (<0.02, 0.02-0.049 and ≥ 0.05 ng/mL, respectively). Survival was studied by Kaplan-Meier curves and the association of variables was tested by Cox regression analysis.
  
  
  RESULTS
  A total of 406 patients was included. Average age was 76.9 (76.0-77.7) years. Hypertensive heart disease was the most common etiology. Left ventricular ejection fraction was <45% in 22.1% of the patients. The group with elevated troponin T had higher proportions of women, systolic dysfunction, renal failure and anemia, a lower body mass index and longer hospital stay. At one year, patients with elevated troponin T had higher mortality than patients with normal troponin (35.5 vs. 13.9%, p<0.001). The composite event (mortality and readmissions) was also more frequent (51.6 vs. 30.9%, p<0.001), but there were no differences in readmissions alone. Troponin T ≥ 0.02 ng/mL was independently associated with mortality.
  
  
  CONCLUSIONS
  Elevated troponin T levels are common in patients with heart failure in clinical practice and are associated with increased mortality and events after one year of follow-up.
authors.affiliation: Department of Internal Medicine, Hospital Infanta Margarita, Avenida Góngora s/n, CP: 14940 Cabra, Córdoba, Spain. Electronic address: guesm53@hotmail.com.
authors.forename: María Esther
authors.initials: ME
authors.lastname: Guisado Espartero
authors.affiliation: Department of Internal Medicine, Hospital Infanta Margarita, Avenida Góngora s/n, CP: 14940 Cabra, Córdoba, Spain.
authors.forename: Prado
authors.initials: P
authors.lastname: Salamanca-Bautista
authors.affiliation: Department of Internal Medicine, Hospital Infanta Margarita, Avenida Góngora s/n, CP: 14940 Cabra, Córdoba, Spain.
authors.forename: Oscar
authors.initials: O
authors.lastname: Aramburu-Bodas
authors.affiliation: Department of Internal Medicine, Hospital Infanta Margarita, Avenida Góngora s/n, CP: 14940 Cabra, Córdoba, Spain.
authors.forename: Jose L
authors.initials: JL
authors.lastname: Arias-Jimenez
authors.affiliation: Department of Internal Medicine, Hospital Infanta Margarita, Avenida Góngora s/n, CP: 14940 Cabra, Córdoba, Spain.
authors.forename: Francesc
authors.initials: F
authors.lastname: Formiga
authors.affiliation: Department of Internal Medicine, Hospital Infanta Margarita, Avenida Góngora s/n, CP: 14940 Cabra, Córdoba, Spain.
authors.forename: Bernardino
authors.initials: B
authors.lastname: Roca-Villanueva
authors.affiliation: Department of Internal Medicine, Hospital Infanta Margarita, Avenida Góngora s/n, CP: 14940 Cabra, Córdoba, Spain.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Cerqueiro-Gonzalez
authors.affiliation: Department of Internal Medicine, Hospital Infanta Margarita, Avenida Góngora s/n, CP: 14940 Cabra, Córdoba, Spain.
authors.forename: Meliton F
authors.initials: MF
authors.lastname: Davila-Ramos
authors.affiliation: Department of Internal Medicine, Hospital Infanta Margarita, Avenida Góngora s/n, CP: 14940 Cabra, Córdoba, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Sanchez-Marteles
authors.affiliation: Department of Internal Medicine, Hospital Infanta Margarita, Avenida Góngora s/n, CP: 14940 Cabra, Córdoba, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Montero-Perez-Barquero
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003718:Denmark; D005260:Female; D006333:Heart Failure / Q000097:blood*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000628:therapy; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D016016:Proportional Hazards Models; D012042:Registries; D020107:Troponin T / Q000032:analysis* / Q000097:blood*
chemical_list: D020107:Troponin T
keywords: Heart failure; Prognosis; Troponin T