High-sensitivity troponin T, NT-proBNP and glomerular filtration rate: A multimarker strategy for risk stratification in chronic heart failure.


Journal

International journal of cardiology
ISSN: 1874-1754
Titre abrégé: Int J Cardiol
Pays: Netherlands
ID NLM: 8200291

Informations de publication

Date de publication:
15 Feb 2019
Historique:
received: 30 04 2018
revised: 28 09 2018
accepted: 24 10 2018
pubmed: 13 11 2018
medline: 4 9 2019
entrez: 13 11 2018
Statut: ppublish

Résumé

In a recent individual patient data meta-analysis, high-sensitivity troponin T (hs-TnT) emerged as robust predictor of prognosis in stable chronic heart failure (HF). In the same population, we compared the relative predictive performances of hs-TnT, N-terminal fraction of pro-B-type natriuretic peptide (NT-proBNP), hs-C-reactive protein (hs-CRP), and estimated glomerular filtration rate (eGFR) for prognosis. 9289 patients (66 ± 12 years, 77% men, 85% LVEF <40%, 60% ischemic HF) were evaluated over a 2.4-year median follow-up. Median eGFR was 58 mL/min/1.73 m hs-TnT conveys independent prognostic information from NT-proBNP, while hs-CRP does not. Concomitant assessment of eGFR may further refine risk stratification. Patient classification according to hs-TnT and NT-proBNP cut-offs specific for the eGFR classes holds prognostic significance.

Sections du résumé

BACKGROUND BACKGROUND
In a recent individual patient data meta-analysis, high-sensitivity troponin T (hs-TnT) emerged as robust predictor of prognosis in stable chronic heart failure (HF). In the same population, we compared the relative predictive performances of hs-TnT, N-terminal fraction of pro-B-type natriuretic peptide (NT-proBNP), hs-C-reactive protein (hs-CRP), and estimated glomerular filtration rate (eGFR) for prognosis.
METHODS AND RESULTS RESULTS
9289 patients (66 ± 12 years, 77% men, 85% LVEF <40%, 60% ischemic HF) were evaluated over a 2.4-year median follow-up. Median eGFR was 58 mL/min/1.73 m
CONCLUSIONS CONCLUSIONS
hs-TnT conveys independent prognostic information from NT-proBNP, while hs-CRP does not. Concomitant assessment of eGFR may further refine risk stratification. Patient classification according to hs-TnT and NT-proBNP cut-offs specific for the eGFR classes holds prognostic significance.

Identifiants

pubmed: 30416028
pii: S0167-5273(18)32769-4
doi: 10.1016/j.ijcard.2018.10.079
pii:
doi:

Substances chimiques

Biomarkers 0
Peptide Fragments 0
Troponin T 0
pro-brain natriuretic peptide (1-76) 0
Natriuretic Peptide, Brain 114471-18-0

Types de publication

Journal Article Meta-Analysis

Langues

eng

Sous-ensembles de citation

IM

Pagination

166-172

Informations de copyright

Copyright © 2018 Elsevier B.V. All rights reserved.

Auteurs

Alberto Aimo (A)

Scuola Superiore Sant'Anna, Pisa, Italy. Electronic address: a.aimo@santannapisa.it.

James L Januzzi (JL)

Massachusetts General Hospital, Harvard Clinical Research Institute, Boston, MA, USA.

Giuseppe Vergaro (G)

Scuola Superiore Sant'Anna, Pisa, Italy; Fondazione Toscana G. Monasterio, Pisa, Italy.

Andrea Ripoli (A)

Fondazione Toscana G. Monasterio, Pisa, Italy.

Roberto Latini (R)

Department of Cardiovascular Research, IRCCS - Istituto di Ricerche Farmacologiche - "Mario Negri", Milano, Italy.

Serge Masson (S)

Department of Cardiovascular Research, IRCCS - Istituto di Ricerche Farmacologiche - "Mario Negri", Milano, Italy.

Michela Magnoli (M)

Department of Cardiovascular Research, IRCCS - Istituto di Ricerche Farmacologiche - "Mario Negri", Milano, Italy.

Inder S Anand (IS)

Division of Cardiovascular Medicine, University of Minnesota, Minneapolis, MN, USA; Department of Cardiology, VA Medical Centre, Minneapolis, MN, USA.

Jay N Cohn (JN)

Division of Cardiovascular Medicine, University of Minnesota, Minneapolis, MN, USA.

Luigi Tavazzi (L)

GVM Hospitals of Care and Research, E.S. Health Science Foundation, Cotignola, Italy.

Gianni Tognoni (G)

Department of Cardiovascular Research, IRCCS - Istituto di Ricerche Farmacologiche - "Mario Negri", Milano, Italy.

Jørgen Gravning (J)

Department of Cardiology, Oslo University Hospital, Ullevål, Oslo, Norway; Centre for Heart Failure Research, University of Oslo, Oslo, Norway.

Thor Ueland (T)

Research Institute of Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway; K. G. Jebsen Thrombosis Research and Expertise Centre, University of Tromsø, Tromsø, Norway.

Ståle H Nymo (SH)

Research Institute of Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.

Hans-Peter Brunner-La Rocca (HB)

Department of Cardiology, Maastricht University Medical Centre, Maastricht, the Netherlands.

Antoni Bayes-Genis (A)

Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.

Josep Lupón (J)

Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.

Rudolf A de Boer (RA)

University Medical Centre Groningen, Groningen, the Netherlands.

Akiomi Yoshihisa (A)

Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.

Yasuchika Takeishi (Y)

Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.

Michael Egstrup (M)

Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Denmark.

Ida Gustafsson (I)

Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Denmark.

Hanna K Gaggin (HK)

Massachusetts General Hospital, Harvard Clinical Research Institute, Boston, MA, USA.

Kai M Eggers (KM)

Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden.

Kurt Huber (K)

Faculty of Internal Medicine, Wilhelminenspital and Sigmund Freud University, Medical School, Vienna, Austria.

Ioannis Tentzeris (I)

Faculty of Internal Medicine, Wilhelminenspital and Sigmund Freud University, Medical School, Vienna, Austria.

W H Wilson Tang (WH)

Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA.

Justin L Grodin (JL)

Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Centre, Dallas, TX, USA.

Claudio Passino (C)

Scuola Superiore Sant'Anna, Pisa, Italy; Fondazione Toscana G. Monasterio, Pisa, Italy.

Michele Emdin (M)

Scuola Superiore Sant'Anna, Pisa, Italy; Fondazione Toscana G. Monasterio, Pisa, Italy.

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Classifications MeSH