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Prognostic Value of Cardiac Troponin I in Patients with Ventricular Tachyarrhythmias
Besides the diagnostic role in acute myocardial infarction, cardiac troponin I levels (cTNI) may be increased in various other clinical conditions, including heart failure, valvular heart disease and sepsis. However, limited data are available regarding the prognostic role of cTNI in the setting of...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9181556/ https://www.ncbi.nlm.nih.gov/pubmed/35683378 http://dx.doi.org/10.3390/jcm11112987 |
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author | Akin, Ibrahim Behnes, Michael Müller, Julian Forner, Jan Abumayyaleh, Mohammad Mashayekhi, Kambis Akin, Muharrem Bertsch, Thomas Weidner, Kathrin Rusnak, Jonas Große Meininghaus, Dirk Kittel, Maximilian Schupp, Tobias |
author_facet | Akin, Ibrahim Behnes, Michael Müller, Julian Forner, Jan Abumayyaleh, Mohammad Mashayekhi, Kambis Akin, Muharrem Bertsch, Thomas Weidner, Kathrin Rusnak, Jonas Große Meininghaus, Dirk Kittel, Maximilian Schupp, Tobias |
author_sort | Akin, Ibrahim |
collection | PubMed |
description | Besides the diagnostic role in acute myocardial infarction, cardiac troponin I levels (cTNI) may be increased in various other clinical conditions, including heart failure, valvular heart disease and sepsis. However, limited data are available regarding the prognostic role of cTNI in the setting of ventricular tachyarrhythmias. Therefore, the present study sought to assess the prognostic impact of cTNI in patients with ventricular tachyarrhythmias (i.e., ventricular tachycardia (VT) and fibrillation (VF)) on admission. A large retrospective registry was used, including all consecutive patients presenting with ventricular tachyarrhythmias from 2002 to 2015. The prognostic impact of elevated cTNI levels was investigated for 30-day all-cause mortality (i.e., primary endpoint) using Kaplan–Meier, receiver operating characteristic (ROC), multivariable Cox regression analyses and propensity score matching. From a total of 1104 patients with ventricular tachyarrhythmias and available cTNI levels on admission, 46% were admitted with VT and 54% with VF. At 30 days, high cTNI was associated with the primary endpoint (40% vs. 22%; log rank p = 0.001; HR = 2.004; 95% CI 1.603–2.505; p = 0.001), which was still evident after multivariable adjustment and propensity score matching (30% vs. 18%; log rank p = 0.003; HR = 1.729; 95% CI 1.184–2.525; p = 0.005). Significant discrimination of the primary endpoint was especially evident in VT patients (area under the curve (AUC) 0.734; 95% CI 0.645–0.823; p = 0.001). In contrast, secondary endpoints, including all-cause mortality at 30 months and a composite arrhythmic endpoint, were not affected by cTNI levels. The risk of cardiac rehospitalization was lower in patients with high cTNI, which was no longer observed after propensity score matching. In conclusion, high cTNI levels were associated with increased risk of all-cause mortality at 30 days in patients presenting with ventricular tachyarrhythmias. |
format | Online Article Text |
id | pubmed-9181556 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-91815562022-06-10 Prognostic Value of Cardiac Troponin I in Patients with Ventricular Tachyarrhythmias Akin, Ibrahim Behnes, Michael Müller, Julian Forner, Jan Abumayyaleh, Mohammad Mashayekhi, Kambis Akin, Muharrem Bertsch, Thomas Weidner, Kathrin Rusnak, Jonas Große Meininghaus, Dirk Kittel, Maximilian Schupp, Tobias J Clin Med Article Besides the diagnostic role in acute myocardial infarction, cardiac troponin I levels (cTNI) may be increased in various other clinical conditions, including heart failure, valvular heart disease and sepsis. However, limited data are available regarding the prognostic role of cTNI in the setting of ventricular tachyarrhythmias. Therefore, the present study sought to assess the prognostic impact of cTNI in patients with ventricular tachyarrhythmias (i.e., ventricular tachycardia (VT) and fibrillation (VF)) on admission. A large retrospective registry was used, including all consecutive patients presenting with ventricular tachyarrhythmias from 2002 to 2015. The prognostic impact of elevated cTNI levels was investigated for 30-day all-cause mortality (i.e., primary endpoint) using Kaplan–Meier, receiver operating characteristic (ROC), multivariable Cox regression analyses and propensity score matching. From a total of 1104 patients with ventricular tachyarrhythmias and available cTNI levels on admission, 46% were admitted with VT and 54% with VF. At 30 days, high cTNI was associated with the primary endpoint (40% vs. 22%; log rank p = 0.001; HR = 2.004; 95% CI 1.603–2.505; p = 0.001), which was still evident after multivariable adjustment and propensity score matching (30% vs. 18%; log rank p = 0.003; HR = 1.729; 95% CI 1.184–2.525; p = 0.005). Significant discrimination of the primary endpoint was especially evident in VT patients (area under the curve (AUC) 0.734; 95% CI 0.645–0.823; p = 0.001). In contrast, secondary endpoints, including all-cause mortality at 30 months and a composite arrhythmic endpoint, were not affected by cTNI levels. The risk of cardiac rehospitalization was lower in patients with high cTNI, which was no longer observed after propensity score matching. In conclusion, high cTNI levels were associated with increased risk of all-cause mortality at 30 days in patients presenting with ventricular tachyarrhythmias. MDPI 2022-05-25 /pmc/articles/PMC9181556/ /pubmed/35683378 http://dx.doi.org/10.3390/jcm11112987 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Akin, Ibrahim Behnes, Michael Müller, Julian Forner, Jan Abumayyaleh, Mohammad Mashayekhi, Kambis Akin, Muharrem Bertsch, Thomas Weidner, Kathrin Rusnak, Jonas Große Meininghaus, Dirk Kittel, Maximilian Schupp, Tobias Prognostic Value of Cardiac Troponin I in Patients with Ventricular Tachyarrhythmias |
title | Prognostic Value of Cardiac Troponin I in Patients with Ventricular Tachyarrhythmias |
title_full | Prognostic Value of Cardiac Troponin I in Patients with Ventricular Tachyarrhythmias |
title_fullStr | Prognostic Value of Cardiac Troponin I in Patients with Ventricular Tachyarrhythmias |
title_full_unstemmed | Prognostic Value of Cardiac Troponin I in Patients with Ventricular Tachyarrhythmias |
title_short | Prognostic Value of Cardiac Troponin I in Patients with Ventricular Tachyarrhythmias |
title_sort | prognostic value of cardiac troponin i in patients with ventricular tachyarrhythmias |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9181556/ https://www.ncbi.nlm.nih.gov/pubmed/35683378 http://dx.doi.org/10.3390/jcm11112987 |
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