title: High-sensitivity troponin T and the risk of recurrent readmissions after hospitalisation for acute heart failure.
abstract: OBJECTIVE
  High-sensitivity troponin is a biomarker of myocardial damage and is associated with a greater risk of mortality and disease progression in patients with acute heart failure (AHF). However, its relationship with the risk of future readmissions is less known. The aim of this study was to assess the association between ultrasensitive troponin T (TnT-us) values in patients with AHF and the risk of recurrent readmissions in the follow-up.
  
  
  METHODS
  We prospectively included a cohort of 621 consecutive patients with AHF, excluding those patients with acute coronary syndrome. We measured the TnT-us levels obtained during the first medical contact in the emergency department. The risk of cumulative readmissions was assessed using negative binomial regression.
  
  
  RESULTS
  The mean age of the participants was 73.6±10.8 years, 54.6% were men, and 52% had a left ventricular systolic function ≥50%. The median TnT-us level was 35.5pg/ml (interquartile range [IQR], 22-67). After a median follow-up of 1.2 years (IQR, 0.4-2.4), a total of 153 deaths (24.6%) were recorded, as well as 689 readmissions for all causes in 303 patients (48.8%) and 286 readmissions for HF in 163 patients (26.3%). In the multivariate analysis, the high TnT-us values were associated with an increased risk of readmission, both for all causes and for HF (incidence rate ratio [IRR], 1.16; 95% confidence interval, 1.02-1.36; p=.029 and IRR, 1.23; 95% confidence interval, 1.04-1.46; p=.018, respectively).
  
  
  CONCLUSIONS
  For patients with AHF, the increase in TnT-us levels was independently associated with a risk of recurrent readmissions during the follow-up.
authors.affiliation: Servicio de Cardiología, Hospital Clínico Universitario de Valencia, INCLIVA, Universitat de Valencia Valencia, España.
authors.forename: D
authors.initials: D
authors.lastname: Escribano
authors.affiliation: Servicio de Cardiología, Hospital Clínico Universitario de Valencia, INCLIVA, Universitat de Valencia Valencia, España.
authors.forename: E
authors.initials: E
authors.lastname: Santas
authors.affiliation: Servicio de Cardiología, Hospital Clínico Universitario de Valencia, INCLIVA, Universitat de Valencia Valencia, España.
authors.forename: G
authors.initials: G
authors.lastname: Miñana
authors.affiliation: Servicio de Cardiología, Hospital Clínico Universitario de Valencia, INCLIVA, Universitat de Valencia Valencia, España.
authors.forename: A
authors.initials: A
authors.lastname: Mollar
authors.affiliation: Servicio de Cardiología, Hospital Clínico Universitario de Valencia, INCLIVA, Universitat de Valencia Valencia, España.
authors.forename: S
authors.initials: S
authors.lastname: García-Blas
authors.affiliation: Servicio de Cardiología, Hospital Clínico Universitario de Valencia, INCLIVA, Universitat de Valencia Valencia, España.
authors.forename: E
authors.initials: E
authors.lastname: Valero
authors.affiliation: Servicio de Cardiología, Hospital Clínico Universitario de Valencia, INCLIVA, Universitat de Valencia Valencia, España.
authors.forename: A
authors.initials: A
authors.lastname: Payá
authors.affiliation: Servicio de Cardiología, Hospital Clínico Universitario de Valencia, INCLIVA, Universitat de Valencia Valencia, España.
authors.forename: F J
authors.initials: FJ
authors.lastname: Chorro
authors.affiliation: Servicio de Cardiología, Hospital Clínico Universitario de Valencia, INCLIVA, Universitat de Valencia Valencia, España.
authors.forename: J
authors.initials: J
authors.lastname: Sanchis
authors.affiliation: Servicio de Cardiología, Hospital Clínico Universitario de Valencia, INCLIVA, Universitat de Valencia Valencia, España. Electronic address: yulnunez@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Núñez
keywords: Heart failure; Hospitalizaciones recurrentes.; Insuficiencia cardíaca; Recurrent readmissions.; Troponina ultrasensible; Ultrasensitive troponin