Prognostic impact of high-sensitive troponin on 30-day mortality in patients with acute heart failure and different classes of left ventricular ejection fraction.

Ledwoch, Jakob; Kraxenberger, Jana; Krauth, Anna; Schneider, Alisa; Leidgschwendner, Katharina; Schneider, Vera; Müller, Alexander; Laugwitz, Karl-Ludwig; Kupatt, Christian; Martens, Eimo

doi:10.1007/s00380-022-02026-x

2022

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Document type:: Article; Journal Article
Author(s):: Ledwoch, Jakob; Kraxenberger, Jana; Krauth, Anna; Schneider, Alisa; Leidgschwendner, Katharina; Schneider, Vera; Müller, Alexander; Laugwitz, Karl-Ludwig; Kupatt, Christian; Martens, Eimo
Title:: Prognostic impact of high-sensitive troponin on 30-day mortality in patients with acute heart failure and different classes of left ventricular ejection fraction.
Abstract:: High-sensitive troponin T (hs-TnT) is increasingly used for prognostication in patients with acute heart failure (AHF). However, uncertainty exists whether hs-TnT shows comparable prognostic performance in patients with heart failure and different classes of left ventricular ejection fraction (LV-EF). The aim of the present study was to assess the prognostic value of hs-TnT for the prediction of 30-day mortality depending on the presence of HF with preserved ejection fraction (HFpEF), HF with mid-range LV-EF (HFmrEF) and HF with reduced LV-EF (HFrEF) in patients with acutely decompensated HF. Patients admitted to our institution due to AHF were retrospectively included. Clinical information was gathered from electronic and paper-based patient charts. Patients with myocardial infarction were excluded. A total of 847 patients were enrolled into the present study. A significant association was found between HF groups and hs-TnT (regression coefficient -0.018 for HFpEF vs. HFmrEF/HFrEF; p = 0.02). The area under the curve (AUC) of hs-TnT for the prediction of 30-mortality was significantly lower in patients with HFpEF (AUC 0.61) than those with HFmrEF (AUC 0.80; p = 0.01) and HFrEF (AUC 0.73; p = 0.04). Hs-TnT was not independently associated with 30-day outcome in the HFpEF group (OR 1.48 [95%-CI 0.89-2.46]; p = 0.13) in contrast to the HFmrEF group (OR 4.53 [95%-CI 1.85-11.1]; p < 0.001) and HFrEF group (OR 2.58 [95%-CI 1.57-4.23]; p < 0.001). Prognostic accuracy of hs-TnT in patients hospitalized for AHF regarding 30-day mortality is significantly lower in patients with HFpEF compared to those with HFmrEF and HFrEF.
Journal title abbreviation:: Heart Vessels
Year:: 2022
Journal volume:: 37
Journal issue:: 7
Pages contribution:: 1195-1202
Fulltext / DOI:: doi:10.1007/s00380-022-02026-x
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/35034171
Print-ISSN:: 0910-8327
TUM Institution:: Klinik und Poliklinik für Innere Medizin I, Kardiologie
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Klinik und Poliklinik für Innere Medizin I, Kardiologie (Prof. Laugwitz)2022