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

被引:3
|
作者
Crisanti, Luca [1 ]
Valli, Gabriele [2 ]
Cennamo, Elisa [1 ]
Capolino, Alessandro [1 ,3 ]
Fratini, Paolo [1 ,4 ]
Cesaro, Claudio [1 ]
Adducchio, Gloria [1 ]
De Magistris, Antonio [1 ]
Terlizzi, Ferdinando [1 ]
Ruggieri, Maria Pia [2 ]
Mirante, Enrico [4 ]
Savoriti, Claudio [4 ]
Sukruang, Kalyarat [5 ]
Valeriano, Valentina [6 ]
Pugliese, Francesco Rocco [6 ]
Travaglino, Francesco [3 ]
Di Somma, Salvatore [1 ,7 ,8 ]
机构
[1] Sapienza Univ Rome, Postgrad Sch Emergency Med, I-00189 Rome, Italy
[2] San Giovanni Addolorata Hosp, Dept Emergency Med, I-00184 Rome, Italy
[3] Univ Campus Biomed Rome, Dept Emergency Med, I-00128 Rome, Italy
[4] St Eugenio Hosp, Dept Emergency Med, I-00144 Rome, Italy
[5] Mahidol Univ, Ramathibodi Hosp, Dept Family Med, Bangkok 10400, Thailand
[6] Sandro Pertini Hosp, Dept Emergency Med, I-00157 Rome, Italy
[7] Sapienza Univ Rome, Fac Med & Psychol, Dept Med Surg Sci & Translat Med, I-00185 Rome, Italy
[8] Great Network, Global Res Acute Condit Team, I-00191 Rome, Italy
来源
MEDICINA-LITHUANIA | 2023年 / 59卷 / 01期
关键词
acute heart failure; high-sensitivity troponin I; left ventricular ejection fraction; risk stratification; emergency department; OUTCOMES;
D O I
10.3390/medicina59010007
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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.
引用
收藏
页数:9
相关论文
共 50 条
  • [21] Risk stratification scores for patients with acute heart failure in the Emergency Department: A systematic review
    Miro, Oscar
    Rossello, Xavier
    Platz, Elke
    Masip, Josep
    Gualandro, Danielle M.
    Peacock, W. Frank
    Price, Susanna
    Cullen, Louise
    DiSomma, Salvatore
    de Oliveira Jr, Mucio Tavares
    McMurray, John J., V
    Martin-Sanchez, Francisco J.
    Maisel, Alan S.
    Vrints, Christiaan
    Cowie, Martin R.
    Bueno, Hector
    Mebazaa, Alexandre
    Mueller, Christian
    EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE, 2020, 9 (05) : 375 - 398
  • [22] High-sensitivity cardiac troponin I in heart failure patients with preserved ejection fraction
    Miyajima, E. Eiji
    Fujii, N.
    Yajima, C.
    Hashiguchi, K.
    Tashiro, Y.
    Takanami, Y.
    Hirose, H.
    Yonezawa, H.
    EUROPEAN JOURNAL OF HEART FAILURE, 2018, 20 : 62 - 62
  • [23] High-Sensitivity Troponin and the Application of Risk Stratification Thresholds in Patients With Suspected Acute Coronary Syndrome
    Bularga, Anda
    Lee, Kuan Ken
    Stewart, Stacey
    Ferry, Amy V.
    Chapman, Andrew R.
    Marshall, Lucy
    Strachan, Fiona E.
    Cruickshank, Anne
    Maguire, Donogh
    Berry, Colin
    Findlay, Iain
    Shah, Anoop S. V.
    Newby, David E.
    Mills, Nicholas L.
    Anand, Atul
    CIRCULATION, 2019, 140 (19) : 1557 - 1568
  • [24] Diagnosis of acute myocardial infarction: super-sensitivity vs. high-sensitivity cardiac troponin I assay
    Brunner, F.
    Schofer, N.
    Schlueter, M.
    Ojeda, F.
    Zeller, T.
    Bickel, C.
    Muenzel, T.
    Keller, T.
    Blankenberg, S.
    Goldmann, B.
    EUROPEAN HEART JOURNAL, 2013, 34 : 1020 - 1021
  • [25] Advancing Emergency Department Chest Pain Risk Stratification With Monocyte Chemoattractant Protein-1 and High-Sensitivity Troponin
    Ashburn, N. P.
    Snavely, A. C.
    Allen, B. R.
    Christenson, R. H.
    Herrington, D. M.
    Hiestand, B. C.
    Miller, C. D.
    Stopyra, J. P.
    Mahler, S. A.
    ANNALS OF EMERGENCY MEDICINE, 2020, 76 (04) : S104 - S104
  • [26] High-sensitivity troponin T and the risk of recurrent readmissions after hospitalisation for acute heart failure
    Escribano, D.
    Santas, E.
    Minana, G.
    Mollar, A.
    Garcia-Bias, S.
    Valero, E.
    Paya, A.
    Chorro, F. J.
    Sanchis, J.
    Nunez, J.
    REVISTA CLINICA ESPANOLA, 2017, 217 (02): : 63 - 70
  • [27] Addition of heart score to high-sensitivity troponin T versus conventional troponin T in risk stratification of patients with chest pain at the coronary emergency rooms
    Willems, M. N. I.
    van de Wijngaart, D. J.
    Bergman, H.
    Adiyaman, A.
    Telting, D.
    Willems, F. F.
    NETHERLANDS HEART JOURNAL, 2014, 22 (12) : 552 - 556
  • [28] Addition of heart score to high-sensitivity troponin T versus conventional troponin T in risk stratification of patients with chest pain at the coronary emergency rooms
    M. N. I. Willems
    D. J. van de Wijngaart
    H. Bergman
    A. Adiyaman
    D. Telting
    F. F. Willems
    Netherlands Heart Journal, 2014, 22 : 552 - 556
  • [29] High-sensitivity C-reactive protein for risk stratification in patients with heart failure
    Bauters, Cbristopbe
    Lamblin, Nicolas
    De Groote, Pascal
    AMERICAN HEART JOURNAL, 2008, 155 (02)
  • [30] Effect of High-sensitivity Troponin on Emergency Department Length of Stay for Patients Evaluated for Acute Coronary Syndrome
    Trent, S.
    Gravitz, S.
    Krantz, M.
    Haukoos, J.
    ANNALS OF EMERGENCY MEDICINE, 2022, 80 (04) : S138 - S138