Use of High-Sensitivity Troponin T to Identify Patients With Acute Heart Failure at Lower Risk for Adverse Outcomes

Pang, Peter S.; Teerlink, John R.; Voors, Adriaan A.; Ponikowski, Piotr; Greenberg, Barry; Filippatos, Gerasimos; Felker, G. Michael; Davison, Beth A.; Cotter, Gad; Kriger, Joshua; Prescott, Margaret F.; Hua, Tsushung A.; Severin, Thomas; Metra, Marco

doi:10.1016/j.jchf.2016.02.009

Cited by 52 publications

(34 citation statements)

References 32 publications

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“…Consistent with previous studies, 7 our patients who had low troponin levels at the time of hospitalization had an uneventful clinical course and all survived. Similar to what was proposed for the patients with acute HF, 22 the detection of normal troponin levels at the time of hospitalization might therefore be considered as a criterion for early discharge from hospital even in a high-risk population such as our patients.…”

Section: Discussionmentioning

confidence: 67%

Characteristics and outcomes of patients hospitalized for COVID-19 and cardiac disease in Northern Italy

Inciardi

Adamo

Lupi

et al. 2020

European Heart Journal

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484

439

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Aims To compare demographic characteristics, clinical presentation, and outcomes of patients with and without concomitant cardiac disease, hospitalized for COVID-19 in Brescia, Lombardy, Italy. Methods and results The study population includes 99 consecutive patients with COVID-19 pneumonia admitted to our hospital between 4 March and 25 March 2020. Fifty-three patients with a history of cardiac disease were compared with 46 without cardiac disease. Among cardiac patients, 40% had a history of heart failure, 36% had atrial fibrillation, and 30% had coronary artery disease. Mean age was 67 ± 12 years, and 80 (81%) patients were males. No differences were found between cardiac and non-cardiac patients except for higher values of serum creatinine, N-terminal probrain natriuretic peptide, and high sensitivity troponin T in cardiac patients. During hospitalization, 26% patients died, 15% developed thrombo-embolic events, 19% had acute respiratory distress syndrome, and 6% had septic shock. Mortality was higher in patients with cardiac disease compared with the others (36% vs. 15%, log-rank P = 0.019; relative risk 2.35; 95% confidence interval 1.08–5.09). The rate of thrombo-embolic events and septic shock during the hospitalization was also higher in cardiac patients (23% vs. 6% and 11% vs. 0%, respectively). Conclusions Hospitalized patients with concomitant cardiac disease and COVID-19 have an extremely poor prognosis compared with subjects without a history of cardiac disease, with higher mortality, thrombo-embolic events, and septic shock rates.

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Section: Discussionmentioning

confidence: 67%

Characteristics and outcomes of patients hospitalized for COVID-19 and cardiac disease in Northern Italy

Inciardi

Adamo

Lupi

et al. 2020

European Heart Journal

Self Cite

484

439

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“…Although, circulating cTn levels below the 99% URL in patients with acute HF may be of low, long-term risk. 14 Yet, there remains a prognostic role for very low levels of circulating cTn 2 , especially when only detectable by increasingly sensitive assays, 15 and whether there is a prognostic advantage apart from lower cTn detection is not clear. Unlike myocardial infarction with a clearer link to pathology and cTn level, changes in cTn levels in HF are not well understood.…”

Section: Introductionmentioning

confidence: 99%

Circulating Cardiac Troponin I Levels Measured by a Novel Highly Sensitive Assay in Acute Decompensated Heart Failure: Insights From the ASCEND-HF Trial

Grodin

Butler

Metra

et al. 2018

Journal of Cardiac Failure

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“…Cardiovascular outcomes at day 180 were observed in low‐baseline and high‐baseline value groups. It was determined that no cardiovascular deaths at day 180 were seen in patients with low hs‐cTNT value, whereas 79 cardiovascular deaths were seen in high‐baseline hs‐cTnT value group …”

Section: Serelaxinmentioning

confidence: 99%

“…It was determined that no cardiovascular deaths at day 180 were seen in patients with low hs-cTNT value, whereas 79 cardiovascular deaths were seen in high-baseline hs-cTnT value group. 48 The details of all the trials are elaborated in Table 2. 49 The important inclusion and exclusion criteria of all the major trials are summarized in Table 3.…”

Section: Phase Imentioning

confidence: 99%

Serelaxin in acute heart failure: Most recent update on clinical and preclinical evidence

Ghosh

Banerjee

Tummala

et al. 2016

Cardiovascular Therapeutics

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SummaryHeart failure continues to be a widely prevalent disease across the world, affecting millions of Americans annually. Acute heart failure (AHF) has a substantial effect on rising healthcare costs and is one of the major causes of morbidity and mortality. The search for new drugs for symptom relief and to improve long-term outcomes in heart failure has led to development of serelaxin, a recombinant human relaxin-2 hormone.Relaxin was discovered in pregnancy, but eventually found to have a number of other physiological actions, not only in pregnancy, but also in nonpregnant women and men.The actions of serelaxin are primarily via nitric oxide, leading to the observed vasodilatory effects, and increase in renal plasma flow. It has also been found to increase expression of vascular endothelial growth factor (VEGF) and matrix metalloproteinase (MMP)-2 and MMP-9. The antifibrotic and antiinflammatory effects of the drug also play a role in heart failure. In Phase II studies, serelaxin has shown reduction in pulmonary arterial pressure, pulmonary capillary wedge pressure, and NT-proBNP. The recently published results of the RELAX-AHF, a phase III clinical trial on serelaxin, has opened new avenues into our understanding of its effects in heart failure. The trial showed improvement in short-term dyspnea scores and 180-day mortality, but, interestingly, failed to show any improvement of the secondary endpoints of death or readmission at 60 days. Ongoing Phase III trials like RELAX-AHF-2 and RELAX-AHF-ASIA would explain these data better and improve understanding of the use of serelaxin in clinical practice. This article summarizes the most updated published preclinical and clinical study data on serelaxin, including pharmacokinetic, pharmacodynamic, safety studies in hepatic, renal impaired patients, Phase II and Phase III trials.

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Use of High-Sensitivity Troponin T to Identify Patients With Acute Heart Failure at Lower Risk for Adverse Outcomes

Abstract: No CV deaths through day 180 were observed in patients with hsTnT levels ≤0.014 μg/l despite high N-terminal pro-brain natriuretic peptide levels. Low baseline hsTnT may identify patients with acute heart failure at very low risk for CV mortality.

Cited by 52 publications

References 32 publications

Characteristics and outcomes of patients hospitalized for COVID-19 and cardiac disease in Northern Italy

Characteristics and outcomes of patients hospitalized for COVID-19 and cardiac disease in Northern Italy

Circulating Cardiac Troponin I Levels Measured by a Novel Highly Sensitive Assay in Acute Decompensated Heart Failure: Insights From the ASCEND-HF Trial

Serelaxin in acute heart failure: Most recent update on clinical and preclinical evidence

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