TY - JOUR
T1 - Persistent increase in cardiac troponin T at hospital discharge predicts repeat hospitalization in patients with acute decompensated heart failure
AU - Takashio, Seiji
AU - Nagai, Toshiyuki
AU - Sugano, Yasuo
AU - Honda, Satoshi
AU - Okada, Atsushi
AU - Asaumi, Yasuhide
AU - Aiba, Takeshi
AU - Noguchi, Teruo
AU - Kusano, Kengo F.
AU - Ogawa, Hisao
AU - Yasuda, Satoshi
AU - Anzai, Toshihisa
AU - Kawakami, Shoji
AU - Yamamoto, Yoshiya
AU - Iwakami, Naotsugu
AU - Yamamoto, Masahiro
AU - Honda, Yasuyuki
AU - Motokawa, Tetsufumi
AU - Hamatani, Yasuhiro
AU - Shibata, Tatsuhiro
AU - Homma, Takehiro
AU - Chinen, Daigo
AU - Yoshida, Chinatsu
AU - Ogura, Sachiko
AU - Sumita, Yoko
N1 - Publisher Copyright:
© 2017 Takashio et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2017/4
Y1 - 2017/4
N2 - Background: High-sensitive cardiac troponin T (hsTnT) is a sensitive biomarker of myocardial damage and predictor of acute decompensated heart failure (ADHF). However, there is little information on changes over time in hsTnT level during ADHF management. The aim of this prospective study was to evaluate changes in hsTnT levels between admission and at discharge in patients with ADHF, and identify factors that determine such levels and their prognostic significance. Methods and results: We evaluated 404 ADHF patients with abnormal hsTnT levels (≥0.0135 ng/ml) on admission. The median (interquartile ranges) hsTnT levels on admission, at discharge, and percent changes in hsTnT levels were 0.038 (0.026 to 0.065), 0.032 (0.021 to 0.049) ng/ml, and-12.0 (-39.8 to 7.4)%respectively. The numbers of patients with falling (hsTnT decrease >-15%), stable (hsTnT change between-15 and +15%) and rising (hsTnT increase > +15%) hsTnT level at discharge were 190, 146, and 68, respectively. The percent change in B-type natriuretic peptide (BNP) levels was greater in the falling group, compared to the stable (p<0.001) and rising groups (p<0.001). Changes in hsTnT levels correlated significantly with changes in BNP levels (ρ = 0.22, p<0.001). Multivariate Cox regression analysis identified rising or stable hsTnT at discharge as a significant predictor of heart failure-related rehospitalization (hazard ratio: 1.69; 95% confidence interval: 1.06 to 2.70; p = 0.03). Conclusions: Persistent increase in hsTnT levels at discharge correlated with inadequate decrease of BNP levels, and was a predictor of poor clinical outcome, with repeat heart failure hospitalizations.
AB - Background: High-sensitive cardiac troponin T (hsTnT) is a sensitive biomarker of myocardial damage and predictor of acute decompensated heart failure (ADHF). However, there is little information on changes over time in hsTnT level during ADHF management. The aim of this prospective study was to evaluate changes in hsTnT levels between admission and at discharge in patients with ADHF, and identify factors that determine such levels and their prognostic significance. Methods and results: We evaluated 404 ADHF patients with abnormal hsTnT levels (≥0.0135 ng/ml) on admission. The median (interquartile ranges) hsTnT levels on admission, at discharge, and percent changes in hsTnT levels were 0.038 (0.026 to 0.065), 0.032 (0.021 to 0.049) ng/ml, and-12.0 (-39.8 to 7.4)%respectively. The numbers of patients with falling (hsTnT decrease >-15%), stable (hsTnT change between-15 and +15%) and rising (hsTnT increase > +15%) hsTnT level at discharge were 190, 146, and 68, respectively. The percent change in B-type natriuretic peptide (BNP) levels was greater in the falling group, compared to the stable (p<0.001) and rising groups (p<0.001). Changes in hsTnT levels correlated significantly with changes in BNP levels (ρ = 0.22, p<0.001). Multivariate Cox regression analysis identified rising or stable hsTnT at discharge as a significant predictor of heart failure-related rehospitalization (hazard ratio: 1.69; 95% confidence interval: 1.06 to 2.70; p = 0.03). Conclusions: Persistent increase in hsTnT levels at discharge correlated with inadequate decrease of BNP levels, and was a predictor of poor clinical outcome, with repeat heart failure hospitalizations.
UR - http://www.scopus.com/inward/record.url?scp=85016957674&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85016957674&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0173336
DO - 10.1371/journal.pone.0173336
M3 - Article
C2 - 28379962
AN - SCOPUS:85016957674
VL - 12
JO - PLoS One
JF - PLoS One
SN - 1932-6203
IS - 4
M1 - e0173336
ER -