title: Prognostic utility of combination of NT-proBNP with high sensitive cTn I in patients with heart failure: Results from retrospective study in an emergency department.
abstract: BACKGROUND
  N-terminal proBNP (NT-proBNP) and cardiac troponin I (cTn I) are widely used for the diagnosis of myocardial injury, but have not been used for routine evaluation in heart failure (HF) population.
  
  
  OBJECTIVE
  To evaluate the prognostic utility of combination of NT-proBNP and cTn I in patients with HF, including serial NT-proBNP/cTn I measurements and discharge NT-proBNP/cTn I levels.
  
  
  METHODS
  A total of 610 patients presenting in our emergency department for acute HF were studied. The mortality and HF-related readmission were endpoints in the study. NT-proBNP and cTn I were tested on admission including first 5 consecutive days, and on discharge.
  
  
  RESULTS
  A discharge cTn I cut-off value at 24 ng/L and discharge NT-proBNP cut-off value at 350 ng/L were determined. The cTn I level more than 24 ng/L and NT-proBNP level more than 350 ng/L are associated with increased risk for mortality and readmission (p < 0.01). The mortality and HF-related readmission was significantly increased in patients with high cTn I + high NT-proBNP (p < 0.05), high cTn I + low NT-proBNP (p < 0.05), and low cTn I + high NT-proBNP (p < 0.0%). The increased cTn I or increased NT-proBNP measured in the first 5 consecutive days were significantly associated with 60-day HF-related events (p < 0.05), but the serial measurements did not have a predictive value of 1-year HF outcome.
  
  
  CONCLUSIONS
  This study demonstrates that elevations of discharge cTn I and NT-proBNP are associated with increased 1-year mortality and HF-related readmission. Patients with increasing serial cTnI and NT-proBNP had increased risk for 60-day HF-related events. The two markers can act as independent predicators, and complete each other in prognostic utility of HF patients.
authors.affiliation: a Intensive Care Unit , Shijiazhuang First Hospital , Shijiazhuang , Hebei Province , China ;
authors.forename: Hui
authors.initials: H
authors.lastname: Cheng
authors.affiliation: b Department of Intern Medicine , Second Hospital Affiliated to Hebei Medical University , Shijiazhuang , Hebei Province , China.
authors.forename: Wei-Ze
authors.initials: WZ
authors.lastname: Fan
authors.affiliation: a Intensive Care Unit , Shijiazhuang First Hospital , Shijiazhuang , Hebei Province , China ;
authors.forename: Sheng-Chi
authors.initials: SC
authors.lastname: Wang
authors.affiliation: a Intensive Care Unit , Shijiazhuang First Hospital , Shijiazhuang , Hebei Province , China ;
authors.forename: Jing
authors.initials: J
authors.lastname: Geng
authors.affiliation: a Intensive Care Unit , Shijiazhuang First Hospital , Shijiazhuang , Hebei Province , China ;
authors.forename: Hui-Ling
authors.initials: HL
authors.lastname: Zang
authors.affiliation: a Intensive Care Unit , Shijiazhuang First Hospital , Shijiazhuang , Hebei Province , China ;
authors.forename: Xiao-Hui
authors.initials: XH
authors.lastname: Shen
authors.affiliation: a Intensive Care Unit , Shijiazhuang First Hospital , Shijiazhuang , Hebei Province , China ;
authors.forename: Zhao-Hui
authors.initials: ZH
authors.lastname: Liu
authors.affiliation: a Intensive Care Unit , Shijiazhuang First Hospital , Shijiazhuang , Hebei Province , China ;
authors.forename: Li-Zhong
authors.initials: LZ
authors.lastname: Wang
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D018450:Disease Progression; D004636:Emergency Service, Hospital; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D012189:Retrospective Studies; D019210:Troponin I / Q000097:blood*
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D019210:Troponin I; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Heart failure; N-terminal proBNP; mortality; troponin I