Prognostic value of high-sensitivity cardiac troponin I in heart failure patients with mid-range and reduced ejection fraction.
<h4>Background</h4>The identification of high-risk heart failure (HF) patients makes it possible to intensify their treatment. Our aim was to determine the prognostic value of a newly developed, high-sensitivity troponin I assay (Atellica®, Siemens Healthcare Diagnostics) for patients wi...
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oai:doaj.org-article:eb66d9e49686403c9ec01e6dbca883172021-12-02T20:08:47ZPrognostic value of high-sensitivity cardiac troponin I in heart failure patients with mid-range and reduced ejection fraction.1932-620310.1371/journal.pone.0255271https://doaj.org/article/eb66d9e49686403c9ec01e6dbca883172021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0255271https://doaj.org/toc/1932-6203<h4>Background</h4>The identification of high-risk heart failure (HF) patients makes it possible to intensify their treatment. Our aim was to determine the prognostic value of a newly developed, high-sensitivity troponin I assay (Atellica®, Siemens Healthcare Diagnostics) for patients with HF with reduced ejection fraction (HFrEF; LVEF < 40%) and HF with mid-range EF (HFmrEF) (LVEF 40%-49%).<h4>Methods and results</h4>A total of 520 patients with HFrEF and HFmrEF were enrolled in this study. Two-year all-cause mortality, heart transplantation, and/or left ventricular assist device implantation were defined as the primary endpoints (EP). A logistic regression analysis was used for the identification of predictors and development of multivariable models. The EP occurred in 14% of the patients, and these patients had higher NT-proBNP (1,950 vs. 518 ng/l; p < 0.001) and hs-cTnI (34 vs. 17 ng/l, p < 0.001) levels. C-statistics demonstrated that the optimal cut-off value for the hs-cTnI level was 17 ng/l (AUC 0.658, p < 0.001). Described by the AUC, the discriminatory power of the multivariable model (NYHA > II, NT-proBNP, hs-cTnI and urea) was 0.823 (p < 0.001). Including heart failure hospitalization as the component of the combined secondary endpoint leads to a diminished predictive power of increased hs-cTnI.<h4>Conclusion</h4>hs-cTnI levels ≥ 17 ng/l represent an independent increased risk of an adverse prognosis for patients with HFrEF and HFmrEF. Determining a patient's hs-cTnI level adds prognostic value to NT-proBNP and clinical parameters.Petr LokajJindrich SpinarLenka SpinarovaFilip MalekOndrej LudkaJan KrejciPetr OstadalDagmar VondrakovaKarel LabrMonika SpinarovaMonika Pavkova GoldbergovaMarie MiklikovaKaterina HelanovaIlona ParenicovaVladimir JakuboKlara BenesovaRoman MiklikJiri JarkovskyTomas OndrusJiri ParenicaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0255271 (2021) |
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Medicine R Science Q Petr Lokaj Jindrich Spinar Lenka Spinarova Filip Malek Ondrej Ludka Jan Krejci Petr Ostadal Dagmar Vondrakova Karel Labr Monika Spinarova Monika Pavkova Goldbergova Marie Miklikova Katerina Helanova Ilona Parenicova Vladimir Jakubo Klara Benesova Roman Miklik Jiri Jarkovsky Tomas Ondrus Jiri Parenica Prognostic value of high-sensitivity cardiac troponin I in heart failure patients with mid-range and reduced ejection fraction. |
| description |
<h4>Background</h4>The identification of high-risk heart failure (HF) patients makes it possible to intensify their treatment. Our aim was to determine the prognostic value of a newly developed, high-sensitivity troponin I assay (Atellica®, Siemens Healthcare Diagnostics) for patients with HF with reduced ejection fraction (HFrEF; LVEF < 40%) and HF with mid-range EF (HFmrEF) (LVEF 40%-49%).<h4>Methods and results</h4>A total of 520 patients with HFrEF and HFmrEF were enrolled in this study. Two-year all-cause mortality, heart transplantation, and/or left ventricular assist device implantation were defined as the primary endpoints (EP). A logistic regression analysis was used for the identification of predictors and development of multivariable models. The EP occurred in 14% of the patients, and these patients had higher NT-proBNP (1,950 vs. 518 ng/l; p < 0.001) and hs-cTnI (34 vs. 17 ng/l, p < 0.001) levels. C-statistics demonstrated that the optimal cut-off value for the hs-cTnI level was 17 ng/l (AUC 0.658, p < 0.001). Described by the AUC, the discriminatory power of the multivariable model (NYHA > II, NT-proBNP, hs-cTnI and urea) was 0.823 (p < 0.001). Including heart failure hospitalization as the component of the combined secondary endpoint leads to a diminished predictive power of increased hs-cTnI.<h4>Conclusion</h4>hs-cTnI levels ≥ 17 ng/l represent an independent increased risk of an adverse prognosis for patients with HFrEF and HFmrEF. Determining a patient's hs-cTnI level adds prognostic value to NT-proBNP and clinical parameters. |
| format |
article |
| author |
Petr Lokaj Jindrich Spinar Lenka Spinarova Filip Malek Ondrej Ludka Jan Krejci Petr Ostadal Dagmar Vondrakova Karel Labr Monika Spinarova Monika Pavkova Goldbergova Marie Miklikova Katerina Helanova Ilona Parenicova Vladimir Jakubo Klara Benesova Roman Miklik Jiri Jarkovsky Tomas Ondrus Jiri Parenica |
| author_facet |
Petr Lokaj Jindrich Spinar Lenka Spinarova Filip Malek Ondrej Ludka Jan Krejci Petr Ostadal Dagmar Vondrakova Karel Labr Monika Spinarova Monika Pavkova Goldbergova Marie Miklikova Katerina Helanova Ilona Parenicova Vladimir Jakubo Klara Benesova Roman Miklik Jiri Jarkovsky Tomas Ondrus Jiri Parenica |
| author_sort |
Petr Lokaj |
| title |
Prognostic value of high-sensitivity cardiac troponin I in heart failure patients with mid-range and reduced ejection fraction. |
| title_short |
Prognostic value of high-sensitivity cardiac troponin I in heart failure patients with mid-range and reduced ejection fraction. |
| title_full |
Prognostic value of high-sensitivity cardiac troponin I in heart failure patients with mid-range and reduced ejection fraction. |
| title_fullStr |
Prognostic value of high-sensitivity cardiac troponin I in heart failure patients with mid-range and reduced ejection fraction. |
| title_full_unstemmed |
Prognostic value of high-sensitivity cardiac troponin I in heart failure patients with mid-range and reduced ejection fraction. |
| title_sort |
prognostic value of high-sensitivity cardiac troponin i in heart failure patients with mid-range and reduced ejection fraction. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2021 |
| url |
https://doaj.org/article/eb66d9e49686403c9ec01e6dbca88317 |
| work_keys_str_mv |
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