Prognostic Utility of Troponin I and N Terminal-ProBNP Among Patients with Heart Failure Due to Non-Ischemic Cardiomyopathy and Important Correlations
BACKGROUND: Heart Failure (HF) is accompanied by a high cost of care and gloomy prognosis despite recent advances in its management. Therefore, efforts to minimize HF rehospitalizations is a major focus of several studies.
METHODS: We conducted a retrospective cohort study of 140 patients 18 years and above who had baseline clinical parameters, echocardiography, NT-ProBNP, troponin I and other laboratory parameters following a 3-year electronic medical record review. Patients with coronary artery disease, preserved ejection fraction, pulmonary embolism, cancer, and end-stage renal disease were excluded.
RESULTS: Of the 140 patients admitted with HF with reduced Ejection Fraction (HFrEF) secondary to non-ischemic cardiomyopathy, 15 were re-hospitalized within 30 days of discharge while 42 were rehospitalized within 6 months after discharge for decompensated HF. Receiver operating characteristic (ROC) cutoff points were obtained for NT-ProBNP at 5178 pg/ml and serum troponin I at 0.045 ng/ml. After Cox regression analysis, patients with HFrEF who had higher hemoglobin levels had reduced odds of re-hospitalization (p = 0.007) within 30 days after discharge. NT-ProBNP and troponin I were independent predictors of re-hospitalization at 6 months after discharge (p = 0.047 and p = 0.02), respectively, after Cox regression analysis.
CONCLUSION: Troponin I and NT-ProBNP at admission are the best predictors of re-hospitalization 6 months after discharge among patients with HFrEF. Hemoglobin is the only predictor of 30 -day rehospitalization among HFrEF patients in this study. High-risk patients may require aggressive therapy to improve outcomes.
Mene-Afejuku, T., Dumancas, C., Akinlonu, A., Ola, O., Cativo, E., Veranyan, S., Lopez, P., Kim, K., Pekler, G., Mushiyev, S., & Visco, F. (2019). Prognostic Utility of Troponin I and N Terminal-ProBNP Among Patients with Heart Failure Due to Non-Ischemic Cardiomyopathy and Important Correlations. Cardiovascular & Hematological Agents in Medicinal Chemistry, 17 (2), 94-103. https://doi.org/10.2174/1871525717666190717160615