Cardiac troponin T as a predictor of cardiac death in patients with left ventricular dysfunction

Abstract

BackgroundCardiac troponin T (cTnT) has been reported to be associated with cardiac mortality.In the present study, we evaluated the role of routine assessment of cTnT as a predictor of future cardiac death in patients with left ventricular (LV) dysfunction.MethodsPatients who were eligible for prophylactic implantable cardioverter defibrillator (ICD) were included from cardiac catheterization database. Inclusion criteria were patients with LV ejection fraction of ≤ 35% and with New York Heart Association (NYHA) ≥class II. Exclusion criteria were patients with acute coronary syndrome, ICD for secondary prevention, NYHA class IV, and lack of data. The final study patients were divided into the following three groups in accordance with two quartile points of serum cTnT levels: low cTnT, intermediate cTnT, and high cTnT groups. The primary endpoint of this study was cardiac death.ResultsA total of 70 patients were included (mean age, 62±13 years; male individuals, 56; ischemic, 36; and non-ischemic, 34). During the observation period of 2.2 years, cardiac death was observed in 17 patients (fatal arrhythmic event, 9; heart failure, 7; myocardial infarction, 1). In the Kaplan–Meier analysis, the high cTnT group showed the highest risk among all the groups (p<0.001). Even in sub-analyses for ischemic and non-ischemic patients, the results were the same, and the high cTnT group showed the highest event rate (p<0.05). In contrast, no cardiac death was observed in the low cTnT group.ConclusionThe cTnT levels in a stable state were associated with cardiac death in patients with LV dysfunction, even in those with non-ischemic diseases.

Redefining Cirrhotic Cardiomyopathy for the Modern Era

“…They also reflect the severity of diastolic and systolic cardiac abnormalities as well as mortality in clinical HF and in CCM . An elevated troponin level in the patient with cirrhosis has been associated with cardiovascular events as well as patient and graft survival and is well known to predict cardiac mortality in acute coronary syndrome and nonischemic heart disease …”

“…(43) An elevated troponin level in the patient with cirrhosis has been associated with cardiovascular events as well as patient and graft survival (47)(48)(49) and is well known to predict cardiac mortality in acute coronary syndrome (50) and nonischemic heart disease. (51) Circulatory modulations in ESLD likely drive cardiac dysfunction in patients with cirrhosis. Activation of the renin-angiotensin-aldosterone system as well as the sympathetic/adrenergic and vasopressin systems suggest that biomarkers such as nitric oxide, endothelin, adrenomedullin, copeptin (provasopressin), vasoactive peptide, endocannabinoids, and bile salts may also be of value in diagnostic assays for CCM risk.…”

Postoperative high-sensitivity troponin T as a predictor of sudden cardiac arrest in patients undergoing cardiac surgery

“…To date, numerous publications have demonstrated a significant relationship between higher troponin values and worse prognosis in patients with acute myocardial infarction, heart failure or severe aortic valve disease [9][10][11][12][13]. It has also been described that TnT is a predictor of cardiac death in patients with CAD, atrial fibrillation or impaired left ventricular function [17][18][19][20][21]. However, Rahimi et al [22] did not show a significant correlation between postmortem TnT level and sudden death.…”

Sudden Cardiac Death: Risk Factors, Causes, Predictors (Literature Review)

“…Міокардіальні стресові біомаркери Підвищений рівень високочутливого серцевого тропоніну (сТ) пов'язаний з випадками ІХС [63]. В одному з досліджень було продемонстровано, що в осіб із підвищеними рівнями сТТ при наявності дисфункції лівого шлуночка і СН II-III функціонального класу частота випадків смерті була вищою, тоді як серед учасників із низьким вмістом сТТ випадки смерті не були зареєстровані [64]. В іншому випробуванні було показано, що зміни концентрації тропоніну, який циркулює, мінімум на 1 значення вище 99 процентиль у клінічних умовах узгоджені з ішемією міокарду; тоді як самі по собі значення вище даної контрольної межі відображають пошкодження міокарду [65].…”