PROGNOSTIC SIGNIFICANCE OF DETECTABLE HIGH-SENSITIVITY CARDIAC TROPONIN T IN STABLE CARDIAC PATIENTS UNDERGOING ELECTIVE CORONARY ANGIOGRAPHY

Abstract Background and Aims High sensitivity cardiac troponin-T (hs-cTnT) are prognostic markers in patients with stable cardiovascular (CV) disease but limited study investigated the CV outcome association in asymptomatic patients receiving hemodialysis (HD). We evaluated the prognostic value of hs-cTnT in predicting CV events in stable HD patients. Method A total of 341 stable HD patients was included in this prospective cohort study. Baseline hs-cTnT was measured by Roche hs-cTnT assays. Patients were followed up for 3 years or until first CV event, which was defined a composite endpoint of acute coronary syndrome, ischemic stroke, or hospitalization for heart failure. Cox proportional hazards model was used to determine independent predictors of CV events. The importance of hs-cTnT compared to other clinical parameters was evaluated by random forests algorithm in Gini index. Results The HD patients enrolled in this study was 59.2 ± 11.5 87 years old, 53.4% male, 42.5% had diabetes, 76.8% had hypertension, 17.6% had coronary artery disease, and 9.1% had cerebrovascular disease. In multivariate Cox regression analysis, the circulating hs-cTnT levels were independent associated with CV events (HR 2.31; 95% CI 1.21-4.40; p-value=0.011) after adjusting for confounders. Multivariable model showed prognostic significance, with the c-statistics of 0.75. The addition of baseline hs-cTnT to established risk factors improved risk prediction of CV events (c-statistics of 0.76; integrated discrimination improvement = 0.02, P = 0.049). Gini index demonstrated hs-cTnT was more important than other clinical parameters for CV events prediction. Conclusion Circulating hs-cTnT levels independently predicted CV events in chronic HD patients. CV risk in HD patients could be stratified according to hs-cTnT levels. The results suggest the useful property of hs-cTnT as an end-organ damage marker reflecting subclinical cardiac injury.

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Impact of high‐sensitivity cardiac troponin T on survival and rehospitalization after transcatheter aortic valve replacement

Catheterization and Cardiovascular Interventions ◽

10.1002/ccd.29781 ◽

2021 ◽

Author(s):

Simon Schoechlin ◽

Undine Schulz ◽

Philip Ruile ◽

Manuel Hein ◽

Martin Eichenlaub ◽

...

Keyword(s):

Aortic Valve ◽

Aortic Valve Replacement ◽

Valve Replacement ◽

Cardiac Troponin ◽

Transcatheter Aortic Valve Replacement ◽

Troponin T ◽

High Sensitivity ◽

Cardiac Troponin T ◽

Transcatheter Aortic Valve

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Evaluation of the 0 h/1 h high-sensitivity cardiac troponin T algorithm in diagnosis of non-ST-segment elevation myocardial infarction (NSTEMI) in Han population

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2020-0367 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Chen Dongxu ◽

Zhou Yannan ◽

Yang Yilin ◽

Yao Chenling ◽

Gu Guorong ◽

...

Keyword(s):

Cardiac Troponin ◽

Troponin T ◽

High Sensitivity ◽

Cardiac Troponin T ◽

Chinese Han ◽

Han Population ◽

St Segment Elevation ◽

Segment Elevation Myocardial Infarction ◽

St Segment ◽

Rule Out

Abstract Objectives A rapid 0 h/1 h algorithm using high-sensitivity cardiac troponin T (hs-cTnT) for rule-out and rule-in of non-ST-segment elevation myocardial infarction (NSTEMI) is recommended by the European Society of Cardiology. We aim to prospectively evaluate the diagnostic performance of the algorithm in Chinese Han patients with suspected NSTEMI. Methods In this prospective diagnostic cohort study, 577 patients presenting to the emergency department with suspected NSTEMI and recent (<12 h) onset of symptoms were enrolled. The levels of serum hs-cTnT were measured on admission, 1 h later and 4–14 h later. All patients underwent the initial clinical assessment and were triaged into three groups (rule-out, rule-in and observe) according to the 0 h/1 h algorithm. The major cardiovascular events (MACE) were evaluated at the 7-day and 30-day follow-ups. Results Among 577 enrolled patients, NSTEMI was the final diagnosis for 106 (18.4%) patients. Based on the hs-cTnT 0 h/1 h algorithm, 148 patients (25.6%) were classified as rule-out, 278 patients (48.2%) as rule-in and 151 patients (26.2%) were assigned to the observe group. The rule-out approach resulted in a sensitivity of 100% and negative predictive value of 100%. The rule-in approach resulted in a specificity of 62.9% [95% CI (58.5–67.2%)] and positive predictive value of 37.1% [95%CI (31.3–42.8%)]. No MACE was observed in the rule-out group within 30-day follow-up. Conclusions The hs-cTnT 0 h/1 h algorithm is a safe tool for early rule-out of NSTEMI, while probably not an effective strategy for accurate rule-in of NSTEMI in Chinese Han population.

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