High-sensitivity troponin T, NT-proBNP and glomerular filtration rate: A multimarker strategy for risk stratification in chronic heart failure

Alberto Aimo*, James L. Januzzi, Giuseppe Vergaro, Andrea Ripoli, Roberto Latini, Serge Masson, Michela Magnoli, Inder S. Anand, Jay N. Cohn, Luigi Tavazzi, Gianni Tognoni, Jorgen Gravning, Thor Ueland, Stale H. Nymo, Hans-Peter Brunner-La Rocca, Antoni Bayes-Genis, Josep Lupon, Rudolf A. de Boer, Akiomi Yoshihisa, Yasuchika TakeishiMichael Egstrup, Ida Gustafsson, Hanna K. Gaggin, Kai M. Eggers, Kurt Huber, Loannis Tentzeris, W. H. Wilson Tang, Justin L. Grodin, Claudio Passino, Michele Emdin

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

19 Citations (Web of Science)

Abstract

Background: In a recent individual patient data meta-analysis, high-sensitivity troponin T (hs-TnT) emerged as robust predictor of prognosis in stable chronic heart failure (HF). In the same population, we compared the relative predictive performances of hs-TnT, N-terminal fraction of pro-B-type natriuretic peptide (NT-proBNP), hs-C-reactive protein (hs-CRP), and estimated glomerular filtration rate (eGFR) for prognosis.

Methods and results: 9289 patients (66 +/- 12 years, 77% men, 85% LVEF = 90: hs-TnT 13 ng/L and NT-proBNP 825 ng/L; eGFR <30: hs-TnT 40 ng/L and NT-proBNP 4608 ng/L). Patient categorization according to these cut-offs effectively stratified patient prognosis across all eGFR classes.

Conclusions: hs-TnT conveys independent prognostic information from NT-proBNP, while hs-CRP does not. Concomitant assessment of eGFR may further refine risk stratification. Patient classification according to hs-TnT and NT-proBNP cut-offs specific for the eGFR classes holds prognostic significance. (C) 2018 Elsevier B.V. All rights reserved.

Original languageEnglish
Pages (from-to)166-172
Number of pages7
JournalInternational Journal of Cardiology
Volume277
DOIs
Publication statusPublished - 15 Feb 2019

Keywords

  • Heart failure
  • Troponin
  • Renal function
  • Prognosis
  • GROWTH-DIFFERENTIATION FACTOR-15
  • LEFT-VENTRICULAR DYSFUNCTION
  • 3RD UNIVERSAL DEFINITION
  • C-REACTIVE PROTEIN
  • EPIDEMIOLOGY COLLABORATION
  • PROGNOSTIC VALUE
  • TASK-FORCE
  • BIOMARKERS
  • GALECTIN-3
  • MORTALITY

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