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

2019 ◽  
Vol 277 ◽  
pp. 166-172 ◽  
Author(s):  
Alberto Aimo ◽  
James L. Januzzi ◽  
Giuseppe Vergaro ◽  
Andrea Ripoli ◽  
Roberto Latini ◽  
...  
Keyword(s):  
Heart Failure ◽  
Glomerular Filtration Rate ◽  
Chronic Heart Failure ◽  
Risk Stratification ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Troponin T ◽  
High Sensitivity ◽  
High Sensitivity Troponin ◽  
High Sensitivity Troponin T

scholarly journals 41 Circulating levels and prognostic cut-offs of sST2, high-sensitivity troponin T, and NT-proBNP in women vs. men with chronic heart failure

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Francesco Gentile ◽  
Alberto Aimo ◽  
James Lj Jannuzzi ◽  
Mark Richards ◽  
Carolyn Sp Lam ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Troponin T ◽  
High Sensitivity ◽  
Cardiovascular Death ◽  
Clinical Value ◽  
High Sensitivity Troponin ◽  
Secondary Endpoints ◽  
High Sensitivity Troponin T ◽  
Circulating Levels

Abstract Aims Limited evidence exists on sex-related differences in clinical value of biomarkers in chronic heart failure (HF). We aimed to define plasma levels, determinants, and optimal prognostic cut-offs of soluble suppression of tumourigenesis-2 (sST2), high-sensitivity troponin T (hs-TnT), and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in female and male chronic HF patients. Methods and results Individual data of patients from the BIOS (Biomarkers In Heart Failure Outpatient Study) Consortium with sST2, hs-TnT, and NT-proBNP measured were analysed. The primary endpoint was a composite of 1-year cardiovascular death and HF hospitalization. The secondary endpoints were 5-year cardiovascular and all-cause death. The cohort included 4540 patients (age: 67 ± 12 years, LVEF 33 ± 13%, 1111 women, 25%). Women showed lower sST2 (24 vs. 27 ng/ml, P < 0.001) and hs-TnT level (15 vs. 20 ng/l, P < 0.001), and similar concentrations of NT-proBNP (1540 vs. 1505 ng/l, P = 0.408). Although the three biomarkers were confirmed as independent predictors of outcome in both sexes, the optimal prognostic cut-off was lower in women for sST2 (28 vs. 31 ng/ml) and hs-TnT (22 vs. 25 ng/l), while NT-proBNP cut-off was higher in women (2339 ng/l vs. 2145 ng/l). The use of sex-specific cut-offs improved risk prediction compared to the use of previously standardized prognostic cut-offs (Figure). Conclusions In patients with chronic HF, levels of sST2 and hs-TnT, but not of NT-proBNP are lower in women. Lower sST2 and hs-TnT and higher NT-proBNP cut-offs for risk stratification could be used in women.

scholarly journals Prognostic Value of High-Sensitivity Troponin T in Chronic Heart Failure

Circulation ◽  
2018 ◽  
Vol 137 (3) ◽  
pp. 286-297 ◽  
Author(s):  
Alberto Aimo ◽  
James L. Januzzi ◽  
Giuseppe Vergaro ◽  
Andrea Ripoli ◽  
Roberto Latini ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Prognostic Value ◽  
Troponin T ◽  
High Sensitivity ◽  
High Sensitivity Troponin ◽  
High Sensitivity Troponin T

scholarly journals sST2 Predicts Outcome in Chronic Heart Failure Beyond NT−proBNP and High-Sensitivity Troponin T

2018 ◽  
Vol 72 (19) ◽  
pp. 2309-2320 ◽  
Author(s):  
Michele Emdin ◽  
Alberto Aimo ◽  
Giuseppe Vergaro ◽  
Antoni Bayes-Genis ◽  
Josep Lupón ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Troponin T ◽  
High Sensitivity ◽  
High Sensitivity Troponin ◽  
High Sensitivity Troponin T

Abstract 12777: High Sensitivity Troponin T is Associated With Increased Heart Failure Risk in Metabolic Syndrome in the Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Yashashwi Pokharel ◽  
Wensheng Sun ◽  
Dennis Villarael ◽  
Elizabeth Selvin ◽  
Salim Virani ◽  
...  
Keyword(s):  
Heart Failure ◽  
Metabolic Syndrome ◽  
Myocardial Injury ◽  
Troponin T ◽  
Cox Model ◽  
High Sensitivity ◽  
Cvd Risk ◽  
Chi Square ◽  
High Sensitivity Troponin ◽  
High Sensitivity Troponin T

Background: Metabolic syndrome (MS) is associated with higher CVD risk. High sensitivity troponin T (hsTnT) is a marker of myocardial injury and an emerging marker for heart failure (HF) risk prediction. We examined whether hsTnT is associated with increased HF risk in people with similar number of MS components present at baseline in 10316 ARIC participants without prevalent HF. Methods: We used Wald Chi-square test to assess the interaction between MS and hsTnT and Cox model for the association of incident HF hospitalization by hsTnT categories across groups created by the number of MS components after adjusting for risk factors and NT-proBNP (Table). Results: The mean age of the study population was 63 (SD, 6) years (56% women). Mean hsTnT levels were higher with increasing MS components (Table). There were 1353 HF hospitalizations over a median of 14 years. The interaction of MS with hsTnT for HF was borderline significant (p-interaction 0.059). Compared to individuals without MS and hsTnT<5 ng/L the HRs (95%CIs) were 1.7 (1.4-2.1) in those without MS and hsTnT≥5 ng/L; 1.7 (1.3-2.1) in MS and hsTnT<5 ng/L; and 3.6 (3.0-4.4) in MS and hsTnT≥5 ng/L. In groups with 1-5 MS components present, increasing hsTnT was significantly associated with higher hazards for HF in each group with the highest HR in those with all 5 MS components (Table). Conclusion: Presence of higher MS risk components was associated with increasing subclinical myocardial injury as assessed by higher hsTnT. The hazards for HF were numerically similar in individuals without MS but detectable hsTnT (>5 ng/L) as to those with MS but undetectable hsTnT. In people with similar number of MS components higher hsTnT levels were associated with increased HF hazards suggesting that in MS hsTnT could be a useful marker for identifying those at higher risk for incident HF.

scholarly journals Arterial hypertension as a trigger for the development of cardiorenal failure in patients of different genders

2019 ◽  
Vol 34 (3) ◽  
pp. 114-121
Author(s):  
E. A. Lopina ◽  
N. P. Grishina ◽  
R. A. Libis
Keyword(s):  
Heart Failure ◽  
Glomerular Filtration Rate ◽  
Chronic Heart Failure ◽  
Ejection Fraction ◽  
Arterial Hypertension ◽  
Glomerular Filtration ◽  
Cystatin C ◽  
Filtration Rate ◽  
Left Ventricular ◽  
Left Ventricular Ejection

Aim. To study the peculiarities of changes in the functional state of the kidneys and heart muscle in patients with arterial hypertension.Materials and Methods. A total of 88 patients with arterial hypertension were included in the study. Chronic kidney disease was detected based on glomerular filtration rate, albuminuria, and cystatin levels in serum and urine. The stage of chronic heart failure was determined according to Strazhesko–Vasilenko classification with functional class according to NYHA; functional class of chronic heart failure was determined based on six-minute walking test. Patient inclusion criteria were the presence of essential hypertension of degree 1–3 and the age from 50 to 70 years. Patients underwent anthropometry, biochemical blood tests, six-minute walking test, and standard echocardiography.Results. Arterial hypertension of degree 1–2 was diagnosed in 50 patients including 33 women and 17 men. Grade 3 arterial hypertension was found in 38 patients (28 women and 10 men). Patients were divided into two groups according to gender. The groups with arterial hypertension degree 1–2 differed in their blood pressure levels. Echocardiography data showed the formation of heart failure with preserved ejection fraction. The groups differed in the values of left ventricular ejection fraction and end-systolic and end-diastolic sizes of the left ventricle. The levels of cystatin C in serum were elevated in both groups. The serum and urine creatinine levels and glomerular filtration rates differed between groups. Women had more significant decreases in the values of glomerular filtration rate, cystatin C, and urine creatinine. Correlation relationships were found between systolic blood pressure and glomerular filtration rate (r = 0.27, p < 0.05) and between systolic blood pressure and left ventricular back wall thickness (r = 0.41, p < 0.05). Inverse relationship was found between left ventricular ejection fraction and albuminuria (r = –0.31, p < 0.05). Cystatin C level had inverse relationship with glomerular filtration rate (r = –0.47, p < 0.05) and direct relationship with left ventricular myocardial mass index (r =  0.24, p  <  0.05).Discussion. Chronic kidney disease and chronic heart failure with preserved left ventricular ejection fraction were detected in patients at early stages. In the group of women, more pronounced changes in the renal and cardiac functions were found. Cystatin C is a marker of kidney function reduction and an alternative marker of chronic heart failure. The study showed that the level of cystatin C in blood serum of patients was increased, which correlated with the functional activities of the kidneys and the heart.Conclusion. In case of arterial hypertension in the presence of chronic kidney disease, the development of the left ventricular hypertrophy and heart failure with preserved ejection fraction was found. Women had more significant changes in the renal and cardiac functions compared with those in men. 

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