engleski

Prognostic value of high sensitive troponin T in patients hospitalized for heart failure

BACKGROUND: Heart failure (HF) is the reason for the growing number of hospitalizations and is one of the leading causes of death in the world, especially Western countries. Although HF therapy has progressed enormously, a high percentage of deaths from this disease continue to be recorded. PURPOSE: In search for a better prediction of outcome for patients with HF, we investigated the role of high sensitive troponin T (hs-TnT) and compared it with already proven marker of cardiac failure, N-terminal pro-B-type natriuretic peptide (NT-proBNP). METHODS: A retrospective study was performed on 315 patients hospitalized at Department of Cardiovascular diseases due to acute decompensated heart failure (ADHF) during 6 months period. Diagnostic approach included laboratory findings, ECG and Echocardiography. Data were collected through the hospital information system. Numerical variables were given as the mean ± standard deviation. Categorical data was expressed in percentages. Mann Whitney test was used in evaluating statistical significance for numerical data, and hi square test for analyzing categorical data. An alpha value of 0.05 was considered significant. Statistical analysis was conducted through program MedCalc. RESULTS: Hs-TnT and NT-proBNP were significantly higher in non survivors compared to survivors (p < 0.001). Significant elevations of hs-TnT and NT-proBNP were noticed in patients who, in addition to heart failure, had also anaemia and chronic renal failure, compared to patients without these comorbidities (p < 0.005). NT-proBNP was predominantly elevated in HFrEF compared to hs-TnT which did not show significant differences according to LV ejection fraction. Unlike NT-proBNP, which did not show important differences between different NYHA classes (P = 0.112), hs-TnT was significantly elevated in NYHA IV compared to lower grades (p < 0.05). NT-proBNP values were significantly elevated in patients older than 85 years compared to patients younger than 65 years, unlike hs-TnT which did not show significant difference according to patients’ age. CONCLUSION: We concluded that hs-TnT has proved to be an excellent predictor of outcome in patients with ADHF, especially with regard to anaemia, chronic renal failure and NYHA class, while it’s significance, with regard to LV ejection fraction, was equal among different values of ejection fractions.

heart failure ; prognosis ; biomarkers ; high sensitive troponin T

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