Profile of patients with acute heart failure and elevated troponin I levels
Jana Sukova1, Petr Ostadal, Petr Widimsky
1Cardiocenter, Department of Cardiology, Third Faculty of Medicine, Charles University in Prague and the University Hospital Kralovske Vinohrady, Prague, Czech Republic.
Insights
Troponin I elevation is common in acute heart failure (AHF). Patients with elevated troponin I showed more severe symptoms and poorer health markers, indicating significant myocardial injury.
Area of Science:
- Cardiology
- Biomarkers
- Heart Failure
Background:
- Troponin I (TnI) elevation indicates myocardial injury.
- TnI elevation is known in chronic and decompensated heart failure.
- Characteristics of TnI elevation in acute heart failure (AHF) are not well-defined.
Purpose of the Study:
- To determine the proportion of AHF patients with TnI elevation.
- To characterize patients with TnI elevation in AHF.
- To compare clinical and demographic features of TnI-positive and TnI-negative AHF patients.
Main Methods:
- 105 consecutive AHF patients were studied.
- Troponin I levels were measured on admission and 12-24 hours later.
- Demographic and clinical data were compared between TnI+ (≥0.5 µg/L) and TnI- (<0.5 µg/L) groups.
Main Results:
- 26.7% of AHF patients had elevated TnI.
- TnI+ patients had higher Killip stage, lower symptom onset time, higher heart rate, and higher creatinine.
- TnI+ group showed no difference in age, sex, blood pressure, CAD history, ECG, or LVEF compared to TnI- group.
Conclusions:
- TnI elevation is present in a significant portion of unselected AHF patients.
- TnI elevation in AHF is associated with distinct clinical characteristics.
- Elevated TnI in AHF suggests myocardial injury and warrants further investigation.
Background:
Elevation of troponin I (TnI), a sensitive marker of myocardial cell injury, has been described in a portion of patients with chronic heart failure and acute decompensated heart failure. The proportion and characteristics of patients with TnI elevation in an unselected population with acute left heart failure (AHF) are, however, not known.
Patients And Methods:
One hundred five consecutive patients with AHF as the leading diagnosis were included in the present study. TnI was routinely assessed at admission and 12 h to 24 h later. Patients with TnI 0.5 mug/L or greater (TnI+ group) and TnI less than 0.5 mug/L (TnI- group) were compared from demographic and clinical points of view.
Results:
TnI elevation was detected in a total of 28 patients with AHF (26.7%). The TnI+ patients had a significantly higher entry Killip stage (P<0.0001), lower time from onset of symptoms (P=0.002), higher baseline heart rate (P=0.003) and creatinine level (P=0.002), and lower body mass index (P=0.03). On the other hand, the TnI+ group did not differ from TnI- patients in demographic and some clinical parameters, such as age, sex, blood pressure, history of coronary artery disease, major electrocardiograph parameters and left ventricular ejection fraction.
Conclusions:
TnI elevation was present in a substantial portion of unselected patients with AHF as the leading clinical diagnosis. Moreover, TnI+ patients differed from those with normal TnI in several clinical parameters.
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