Troponina cardíaca T para estratificação de risco na insuficiência cardíaca crônica descompensada

Carlo, Carlos Henrique Del; Pereira-Barretto, Antônio Carlos; Cassaro-Strunz, Célia; Latorre, Maria do Rosário Dias de Oliveira; Oliveira, Múcio Tavares de; Ramires, José Antônio Franchini

doi:10.1590/s0066-782x2009000500012

Cited by 7 publications

(6 citation statements)

References 32 publications

(50 reference statements)

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“…From this perspective, measurement of the troponin level brings additional prognostic information in patients with acute HF, as several studies confirmed [ 72 , 74 , 75 ]. Cardiac troponin was associated with readmission rates and mortality risk in patients with acute HF [ 69 , 75 , 76 ].…”

Section: Discussionmentioning

confidence: 99%

ECG and Biomarker Profile in Patients with Acute Heart Failure: A Pilot Study

et al. 2022

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Background: Biomarkers, electrocardiogram (ECG) and Holter ECG are basic, accessible and feasible cardiac investigations. The combination of their results may lead to a more complex predictive model that may improve the clinical approach in acute heart failure (AHF). The main objective was to investigate which ECG parameters are correlated with the usual cardiac biomarkers (prohormone N-terminal proBNP, high-sensitive cardiac troponin I) in patients with acute heart failure, in a population from Romania. The relationship between certain ECG parameters and cardiac biomarkers may support future research on their combined prognostic value. Methods: In this prospective case-control study were included 49 patients with acute heart failure and 31 participants in the control group. For all patients we measured levels of prohormone N-terminal proBNP (NT-proBNP), high-sensitive cardiac troponin I (hs-cTnI) and MB isoenzyme of creatine phosphokinase (CK-MB) and evaluated the 12-lead ECG and 24 h Holter monitoring. Complete clinical and paraclinical evaluation was performed. Results: NT-proBNP level was significantly higher in patients with AHF (p < 0.001). In patients with AHF, NT-proBNP correlated with cQTi (p = 0.027), pathological Q wave (p = 0.029), complex premature ventricular contractions (PVCs) (p = 0.034) and ventricular tachycardia (p = 0.048). Hs-cTnI and CK-MB were correlated with ST-segment modification (p = 0.038; p = 0.018) and hs-cTnI alone with complex PVCs (p = 0.031). Conclusions: The statistical relationships found between cardiac biomarkers and ECG patterns support the added value of ECG in the diagnosis of AHF. We emphasize the importance of proper ECG analysis of more subtle parameters that can easily be missed. As a non-invasive technique, ECG can be used in the outpatient setting as a warning signal, announcing the acute decompensation of HF. In addition, the information provided by the ECG complements the biomarker results, supporting the diagnosis of AHF in cases of dyspnea of uncertain etiology. Further studies are needed to confirm long-term prognosis in a multi-marker approach.

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Section: Discussionmentioning

confidence: 99%

ECG and Biomarker Profile in Patients with Acute Heart Failure: A Pilot Study

et al. 2022

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“…Del Carlo et al described the relevance of cardiac troponin T for risk stratification 12. Santos analyzed the quality of life in this group of patients 13.…”

Section: Methodsmentioning

confidence: 99%

A review of cardiopulmonary research in Brazilian medical journals: clinical, surgical and epidemiological data

Serrano

Silva

2010

Clinics

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Research in the field of cardiopulmonary disease in Brazil has been very active in recent decades. The combination of PUBMED, SCieLO, open access and online searching has provided a significant increase in the visibility of Brazilian journals. This newly acquired international visibility has in turn resulted in the appearance of more original research reports in the Brazilian scientific press. This review is intended to highlight part of this work for the benefit of the readers of “Clinics.” We searched through PUBMED for noteworthy articles published in Brazilian medical journals included in the Journal of Citation Reports of the Institute of Scientific Information to better expose them to our readership. The following journals were examined: “Arquivos Brasileiros de Cardiologia,” “Arquivos Brasileiros de Endocrinologia e Metabologia,” “Brazilian Journal of Medical and Biological Reviews,” “Jornal Brasileiro de Pneumologia,” “Jornal de Pediatria,” “Revista Brasileira de Cirurgia Cardiovascular,” “Revista da Associação Médica Brasileira,” Revista da Escola de Enfermagem U.S.P.” and “São Paulo Medical Journal.” These journals publish original investigations in the field of cardiopulmonary disease. The search produced 71 references, which are briefly examined.

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“…Other small scale studies [38,39] have demonstrated that elevated troponin I is associated with lower ejection fraction, higher systolic pulmonary artery pressure and increased length of hospital stay. Moreover, abnormal troponin T is a predictor of increased risk of HF readmission and mortality [40,41]. These associations have persisted up to 3 years from the index hospitalization.…”

Section: Heart Failurementioning

confidence: 98%

“…Del Carlo C.H. et al [40] 70 patients with chronic HF worsening that needed hospitalization were studied.…”

Section: Heart Failurementioning

confidence: 99%

Benefits of Home-Based Solutions for Diagnosis and Treatment of Acute Coronary Syndromes on Health Care Costs: A Systematic Review

Redon

Shahzad

Iqbal

et al. 2020

Sensors

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Diagnosing and treating acute coronary syndromes consumes a significant fraction of the healthcare budget worldwide. The pressure on resources is expected to increase with the continuing rise of cardiovascular disease, other chronic diseases and extended life expectancy, while expenditure is constrained. The objective of this review is to assess if home-based solutions for measuring chemical cardiac biomarkers can mitigate or reduce the continued rise in the costs of ACS treatment. A systematic review was performed considering published literature in several relevant public databases (i.e., PUBMED, Cochrane, Embase and Scopus) focusing on current biomarker practices in high-risk patients, their cost-effectiveness and the clinical evidence and feasibility of implementation. Out of 26,000 references screened, 86 met the inclusion criteria after independent full-text review. Current clinical evidence highlights that home-based solutions implemented in primary and secondary prevention reduce health care costs by earlier diagnosis, improved patient outcomes and quality of life, as well as by avoidance of unnecessary use of resources. Economical evidence suggests their potential to reduce health care costs if the incremental cost-effectiveness ratio or the willingness-to-pay does not surpass £20,000/QALY or €50,000 limit per 20,000 patients, respectively. The cost-effectiveness of these solutions increases when applied to high-risk patients.

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Troponina cardíaca T para estratificação de risco na insuficiência cardíaca crônica descompensada

Abstract: The increase in cTnT is associated with a bad prognosis in decompensated HF and the degree of this increase can help the risk stratification.

Cited by 7 publications

References 32 publications

ECG and Biomarker Profile in Patients with Acute Heart Failure: A Pilot Study

ECG and Biomarker Profile in Patients with Acute Heart Failure: A Pilot Study

A review of cardiopulmonary research in Brazilian medical journals: clinical, surgical and epidemiological data

Benefits of Home-Based Solutions for Diagnosis and Treatment of Acute Coronary Syndromes on Health Care Costs: A Systematic Review

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