title: EAHFE - TROPICA2 study. Prognostic value of troponin in patients with acute heart failure treated in Spanish hospital emergency departments.
abstract: OBJECTIVE
  Evaluate the use of different cardiac troponin (cTn) immunoassays and the prognostic value of increased cTn values in patients diagnosed with acute heart failure (AHF) in the emergency department (ED).
  
  
  METHODS
  The epidemiology acute heart failure emergency-TROPonin in acute heart failure2 (EAHFE-TROPICA2) is a retrospective study including patients with AHF admitted in 34 Spanish EDs with cTn values determined in the ED. We studied the prevalence of elevated troponin (value above the established reference limit) for the different types of troponin. We also assessed crude and adjusted primary (1-year all-cause death) and secondary (30 d ED revisit due to AHF) outcomes for every type of cTn and different magnitudes of troponin elevation.
  
  
  RESULTS
  We analysed 4705 episodes of AHF. Troponin was elevated in 48.4% of the cases (25.3% in cTnI, 37.9% in cTnT and 82.2% in hs-cTnT). Mortality at one year was higher in patients with elevated troponin (adjusted HR 1.61; CI 95% 1.38-1.88) regardless of the type of cTn determined. Elevated troponin was not related to ED revisit within 30 d after discharge (1.01; 0.87-1.19).
  
  
  CONCLUSIONS
  The use of conventional troponin in the ED is useful to predict one-year mortality in patients with AHF. Highly sensitive cTnT (hs-cTnT) elevations less than double the reference value have no impact on patient outcome.
authors.affiliation: a Emergency Department , Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat , Barcelona , Catalonia , Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Jacob
authors.affiliation: a Emergency Department , Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat , Barcelona , Catalonia , Spain.
authors.forename: Alex
authors.initials: A
authors.lastname: Roset
authors.affiliation: b Emergency Department , Hospital Clínic, Research Group "Emergencies: processes and diseases", IDIBAPS , Barcelona , Catalonia , Spain.
authors.forename: Òscar
authors.initials: Ò
authors.lastname: Miró
authors.affiliation: c Emergency Department , Hospital de la Santa Creu i Sant Pau , Barcelona , Catalonia , Spain.
authors.forename: Aitor
authors.initials: A
authors.lastname: Alquézar
authors.affiliation: d Emergency Department , Hospital Universitario Central de Asturias , Oviedo , Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Herrero
authors.affiliation: e Emergency Department , Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC) , Madrid , Spain.
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Martín-Sanchez
authors.affiliation: f Department of Cardiology Division of Emergency Medicine , Charité-University Medicine Berlin , Berlin , Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Möckel
authors.affiliation: g Department of Cardiology & Cardiovascular Research Institute Basel , University Hospital Basel , Basel , Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Müller
authors.affiliation: h Department of Emergency Medicine, Short-Stay Unit and Hospital at-home , Hospital General Universitario de Alicante , Alicante , Spain.
authors.forename: Pere
authors.initials: P
authors.lastname: Llorens
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis* / Q000401:mortality*; D006801:Humans; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D013030:Spain; D016896:Treatment Outcome; D014336:Troponin / Q000097:blood*
chemical_list: D014336:Troponin
keywords: Cardiovascular disease; renal disease; respiratory disease