2010年1月
Prognostic role of highly sensitive cardiac troponin I in patients with systolic heart failure
AMERICAN HEART JOURNAL
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- 巻
- 159
- 号
- 1
- 開始ページ
- 63
- 終了ページ
- 67
- 記述言語
- 英語
- 掲載種別
- DOI
- 10.1016/j.ahj.2009.10.022
- 出版者・発行元
- MOSBY-ELSEVIER
Background Cardiac troponin T (cTnT) and cardiac troponin I (cTnI) are useful biomarkers in patients with chronic heart failure (CHF). However, the clinical use has limitations due to the low sensitivity of a conventional commercial assay system. Recently, a high sensitive-cTnI (hs-cTnI) commercial assay has become available.
Methods To compare the prognostic value of cTnT and hs-cTnI, we measured hemodynamic parameters and serum levels of cTnT, hs-cTnI and N-terminal pro-brain natriuretic peptide (NT-proBNP) in 258 consecutive CHF patients and then followed these patients for a mean period of 2.6 years. In both assays of cTnT and hs-cTnI, the lowest concentration at which the coefficient of variation was <= 10% were 0.03 ng/mL, respectively. Therefore, in the present study, an elevated cTnT or cTnI test was defined as a level of >= 0.03 ng/mL.
Results During long-term follow up, there were 20 cardiac deaths. In 258 CHF patients, serum cTnT were elevated (>= 0.03 ng/mL) in 32 patients (12%) and serum hs-cTnI was elevated (>= 0.03 ng/mL) in 112 patients (43%). On stepwise multivariate analyses, high plasma NT-proBNP (>= 627 pg/mL, P = .0063) and hs-cTnI (>= 0.03 ng/mL) (P = .016) were independent significant prognostic predictors but cTnT (>= 0.03 ng/mL) was not. The hazard ratio for mortality of patients with high plasma NT-proBNP (>= 627 pg/mL) and hs-cTnI (>= 0.03 ng/mL) was 5.74 (95% CI, 2.33-14.28, P<.0001) compared to that of those with low NT-proBNP (<627 pg/mL) or hs-cTnI (<0.03 ng/mL).
Conclusions These findings indicate that a high plasma concentration of hs-cTnI is an independent and useful prognostic predictor in patients with CHF. (Am Heart J 2010; 159: 63-7.)
Methods To compare the prognostic value of cTnT and hs-cTnI, we measured hemodynamic parameters and serum levels of cTnT, hs-cTnI and N-terminal pro-brain natriuretic peptide (NT-proBNP) in 258 consecutive CHF patients and then followed these patients for a mean period of 2.6 years. In both assays of cTnT and hs-cTnI, the lowest concentration at which the coefficient of variation was <= 10% were 0.03 ng/mL, respectively. Therefore, in the present study, an elevated cTnT or cTnI test was defined as a level of >= 0.03 ng/mL.
Results During long-term follow up, there were 20 cardiac deaths. In 258 CHF patients, serum cTnT were elevated (>= 0.03 ng/mL) in 32 patients (12%) and serum hs-cTnI was elevated (>= 0.03 ng/mL) in 112 patients (43%). On stepwise multivariate analyses, high plasma NT-proBNP (>= 627 pg/mL, P = .0063) and hs-cTnI (>= 0.03 ng/mL) (P = .016) were independent significant prognostic predictors but cTnT (>= 0.03 ng/mL) was not. The hazard ratio for mortality of patients with high plasma NT-proBNP (>= 627 pg/mL) and hs-cTnI (>= 0.03 ng/mL) was 5.74 (95% CI, 2.33-14.28, P<.0001) compared to that of those with low NT-proBNP (<627 pg/mL) or hs-cTnI (<0.03 ng/mL).
Conclusions These findings indicate that a high plasma concentration of hs-cTnI is an independent and useful prognostic predictor in patients with CHF. (Am Heart J 2010; 159: 63-7.)
- リンク情報
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- DOI
- https://doi.org/10.1016/j.ahj.2009.10.022
- CiNii Articles
- http://ci.nii.ac.jp/naid/10028102248
- PubMed
- https://www.ncbi.nlm.nih.gov/pubmed/20102868
- Web of Science
- https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000273051300009&DestApp=WOS_CPL
- ID情報
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- DOI : 10.1016/j.ahj.2009.10.022
- ISSN : 0002-8703
- CiNii Articles ID : 10028102248
- PubMed ID : 20102868
- Web of Science ID : WOS:000273051300009