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.
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页数:9
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