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Usefulness of High-Sensitivity Troponin I in Risk Stratification and Final Disposition of Patients with Acute Heart Failure in the Emergency Department: Comparison between HFpEF vs. HFrEF
Background and Objectives: In patients with acute heart failure (AHF), there is no definite evidence on the relationship between high-sensitivity cardiac troponin (hs-cTnI) and the left ventricular ejection fraction (LVEF) comparing the reduced and preserved EF conditions. Materials and Methods: Bet...
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/PMC9864783/ https://www.ncbi.nlm.nih.gov/pubmed/36676630 http://dx.doi.org/10.3390/medicina59010007 |
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author | Crisanti, Luca Valli, Gabriele Cennamo, Elisa Capolino, Alessandro Fratini, Paolo Cesaro, Claudio Adducchio, Gloria De Magistris, Antonio Terlizzi, Ferdinando Ruggieri, Maria Pia Mirante, Enrico Savoriti, Claudio Sukruang, Kalyarat Valeriano, Valentina Pugliese, Francesco Rocco Travaglino, Francesco Di Somma, Salvatore |
author_facet | Crisanti, Luca Valli, Gabriele Cennamo, Elisa Capolino, Alessandro Fratini, Paolo Cesaro, Claudio Adducchio, Gloria De Magistris, Antonio Terlizzi, Ferdinando Ruggieri, Maria Pia Mirante, Enrico Savoriti, Claudio Sukruang, Kalyarat Valeriano, Valentina Pugliese, Francesco Rocco Travaglino, Francesco Di Somma, Salvatore |
author_sort | Crisanti, Luca |
collection | PubMed |
description | Background and Objectives: In patients with acute heart failure (AHF), there is no definite evidence on the relationship between high-sensitivity cardiac troponin (hs-cTnI) and the left ventricular ejection fraction (LVEF) comparing the reduced and preserved EF conditions. Materials and Methods: Between January and April 2022, we retrospectively analyzed the data from 386 patients admitted to the emergency departments (ED) of five hospitals in Rome, Italy, for AHF. The criteria for inclusion were a final diagnosis of AHF; a cardiac ultrasound and hs-cTnI evaluations in the ED; and age > 18 yrs. We excluded patients with acute coronary syndrome (ACS). Based on echocardiography and hs-cTnI evaluations, the patients were grouped for (1) preserved (HFpEF) or (2) reduced LVEF (HFrEF) and a a) negative (within the normal range value) or b) positive (above the normal range value) of hs-cTnI, respectively. Results: There was a significant negative relationship between a positive test for hs-cTnI and LVEF. When compared to the group with a negative hs-cTnI test, the patients with a positive test, both from the HFpEF and HFrEF subgroups, were significantly more likely to have an adverse outcome, such as being admitted to the intensive care unit (ICU) or dying in the ED. Moreover, a reduced ejection fraction was linked with a final disposition to a higher level of care. Conclusions: In patients admitted to the ED for AHF without ACS, there is a negative relationship between hs-cTnI and a reduced LVEF, although a significant percentage of patients with a preserved LVEF also resulted to have high levels of hs-cTnI. In the absence of ACS, hs-cTnI seems to be a reliable biomarker of myocardial injury in AHF in the ED and should be considered as a risk stratification parameter for these subjects regardless of the left ventricular function. Further larger prospective studies are needed to confirm these preliminary data. |
format | Online Article Text |
id | pubmed-9864783 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-98647832023-01-22 Usefulness of High-Sensitivity Troponin I in Risk Stratification and Final Disposition of Patients with Acute Heart Failure in the Emergency Department: Comparison between HFpEF vs. HFrEF Crisanti, Luca Valli, Gabriele Cennamo, Elisa Capolino, Alessandro Fratini, Paolo Cesaro, Claudio Adducchio, Gloria De Magistris, Antonio Terlizzi, Ferdinando Ruggieri, Maria Pia Mirante, Enrico Savoriti, Claudio Sukruang, Kalyarat Valeriano, Valentina Pugliese, Francesco Rocco Travaglino, Francesco Di Somma, Salvatore Medicina (Kaunas) Article Background and Objectives: In patients with acute heart failure (AHF), there is no definite evidence on the relationship between high-sensitivity cardiac troponin (hs-cTnI) and the left ventricular ejection fraction (LVEF) comparing the reduced and preserved EF conditions. Materials and Methods: Between January and April 2022, we retrospectively analyzed the data from 386 patients admitted to the emergency departments (ED) of five hospitals in Rome, Italy, for AHF. The criteria for inclusion were a final diagnosis of AHF; a cardiac ultrasound and hs-cTnI evaluations in the ED; and age > 18 yrs. We excluded patients with acute coronary syndrome (ACS). Based on echocardiography and hs-cTnI evaluations, the patients were grouped for (1) preserved (HFpEF) or (2) reduced LVEF (HFrEF) and a a) negative (within the normal range value) or b) positive (above the normal range value) of hs-cTnI, respectively. Results: There was a significant negative relationship between a positive test for hs-cTnI and LVEF. When compared to the group with a negative hs-cTnI test, the patients with a positive test, both from the HFpEF and HFrEF subgroups, were significantly more likely to have an adverse outcome, such as being admitted to the intensive care unit (ICU) or dying in the ED. Moreover, a reduced ejection fraction was linked with a final disposition to a higher level of care. Conclusions: In patients admitted to the ED for AHF without ACS, there is a negative relationship between hs-cTnI and a reduced LVEF, although a significant percentage of patients with a preserved LVEF also resulted to have high levels of hs-cTnI. In the absence of ACS, hs-cTnI seems to be a reliable biomarker of myocardial injury in AHF in the ED and should be considered as a risk stratification parameter for these subjects regardless of the left ventricular function. Further larger prospective studies are needed to confirm these preliminary data. MDPI 2022-12-20 /pmc/articles/PMC9864783/ /pubmed/36676630 http://dx.doi.org/10.3390/medicina59010007 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 Crisanti, Luca Valli, Gabriele Cennamo, Elisa Capolino, Alessandro Fratini, Paolo Cesaro, Claudio Adducchio, Gloria De Magistris, Antonio Terlizzi, Ferdinando Ruggieri, Maria Pia Mirante, Enrico Savoriti, Claudio Sukruang, Kalyarat Valeriano, Valentina Pugliese, Francesco Rocco Travaglino, Francesco Di Somma, Salvatore Usefulness of High-Sensitivity Troponin I in Risk Stratification and Final Disposition of Patients with Acute Heart Failure in the Emergency Department: Comparison between HFpEF vs. HFrEF |
title | Usefulness of High-Sensitivity Troponin I in Risk Stratification and Final Disposition of Patients with Acute Heart Failure in the Emergency Department: Comparison between HFpEF vs. HFrEF |
title_full | Usefulness of High-Sensitivity Troponin I in Risk Stratification and Final Disposition of Patients with Acute Heart Failure in the Emergency Department: Comparison between HFpEF vs. HFrEF |
title_fullStr | Usefulness of High-Sensitivity Troponin I in Risk Stratification and Final Disposition of Patients with Acute Heart Failure in the Emergency Department: Comparison between HFpEF vs. HFrEF |
title_full_unstemmed | Usefulness of High-Sensitivity Troponin I in Risk Stratification and Final Disposition of Patients with Acute Heart Failure in the Emergency Department: Comparison between HFpEF vs. HFrEF |
title_short | Usefulness of High-Sensitivity Troponin I in Risk Stratification and Final Disposition of Patients with Acute Heart Failure in the Emergency Department: Comparison between HFpEF vs. HFrEF |
title_sort | usefulness of high-sensitivity troponin i in risk stratification and final disposition of patients with acute heart failure in the emergency department: comparison between hfpef vs. hfref |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9864783/ https://www.ncbi.nlm.nih.gov/pubmed/36676630 http://dx.doi.org/10.3390/medicina59010007 |
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