Highly sensitive cardiac troponin T for prognosis prediction in patients with nonischemic chronic systolic heart failure
Fang Shanjuan
Wang Chunmei
Ai Hui
Que Bin
Nie Shaoping
Abstract：Objective To assess the prognostic impact of highly sensitive cardiac troponin T (hs-cTnT) on nonischemic chronic systolic heart failure.Methods One hundred and seventeen patients with nonischemic chronic systolic heart failure whose left ventricular ejection fraction (LVEF) ≤40％ from November 2012 to September 2015 were consecutively enrolled.Echocardiograph,hs-cTnT,N-terminal pro-brain natriuretic peptide (NT-proBNP) and creatinine level were measured.Elevated serum hs-cTnT level was defined as hs-cTnT ≥ 0.013 μg/L.Results The follow-up were completed in 108 patients [92.3％ (108/117)],who were divided into 2 groups:survival group and non-survival group (94/14).The ratio of Ⅲ-Ⅳ stage of New York Heart Association functional classification,the ratio of elevated hs-cTnT level,the level of NT-proBNP and the left ventricular enddiastolic diameter (LVEDD) in non-survival group were all significantly higher than those in survival group [78.6％ (11/14) vs 39.4％ (37/94),92.9％ (13/14) vs 50.0％ (47/94),4 221 (2 200,5 557)ng/L vs 1 194 (627,2 093)ng/L,(72 ±5)mm vs (68 ±6)mm] (all P ＜0.05).The LVEF in non-suvival group was significantly lower than that in survival group [(27 ± 7) ％ vs (31 ± 6) ％] (P ＜ 0.05).In 94 patients (87.0％) with detective hs-cTnT level≥0.003 μg/L,the serum concentration of hs-cTnT in non-survival group (14 cases) was significantly higher than that in survival group (80 cases) [0.030(0.018,0.052) μg/L vs 0.016(0.006,0.026) μg/L] (P ＜0.001).According to the hs-cTnT level,108 patients were divided into 2 groups:the group with hs-cTnT ≥0.013 μg/L and the group with hs-cTnT ＜ 0.013 μg/L (59/49).Kaplan-Meier curves showed that the cumulative survival rate of the group with hs-cTnT≥0.013 μg/L was significantly lower than that of the group with hs-cTnT ＜ 0.013 μg/L (P =0.016).Multivariate Cox regression analysis showed that hs-cTnT ≥ 0.013 μg/L [odds ratio (OR) =3.95,95％ confidence interval (CI):1.28-11.30,P =0.023] and a high plama level of NT-proBNP (OR =1.002,95％ CI:1.001-1.003,P ＜ 0.001) were independent prognostic predictive factors of nonischemic chronic systolic heart failure.Conclusion A high serum level of hs-cTnT (≥0.013 μg/L) is an independent prognostic predictive factor of nonischemic chronic systolic heart failure.
Keywords：Heart failureHighly sensitive cardiac troponin TPrognosisN-terminal pro-B-type natriuretic peptide
Publication Date：2016-06-30
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 785-789 )