Prognostic value of cardiac troponin I in patients with ventricular tachyarrhythmias

• Verfasst von: Akın, Ibrahim [VerfasserIn]
• Verfasst von: Behnes, Michael [VerfasserIn]
• Verfasst von: Müller, Julian [VerfasserIn]
• Verfasst von: Forner, Jan [VerfasserIn]
• Verfasst von: Abumayyaleh, Mohammad S. A. [VerfasserIn]
• Verfasst von: Mashayekhi, Kambis [VerfasserIn]
• Verfasst von: Akın, Muharrem [VerfasserIn]
• Verfasst von: Bertsch, Thomas [VerfasserIn]
• Verfasst von: Weidner, Kathrin [VerfasserIn]
• Verfasst von: Rusnak, Jonas [VerfasserIn]
• Verfasst von: Große Meininghaus, Dirk [VerfasserIn]
• Verfasst von: Kittel, Maximilian [VerfasserIn]
• Verfasst von: Schupp, Tobias [VerfasserIn]
• Titel: Prognostic value of cardiac troponin I in patients with ventricular tachyarrhythmias
• Verf.angabe: Ibrahim Akin, Michael Behnes, Julian Müller, Jan Forner, Mohammad Abumayyaleh, Kambis Mashayekhi, Muharrem Akin, Thomas Bertsch, Kathrin Weidner, Jonas Rusnak, Dirk Große Meininghaus, Maximilian Kittel and Tobias Schupp
• E-Jahr: 2022
• Jahr: 25 May 2022
• Umfang: 20 S.
• Fussnoten: Dieser Artikel gehört zum Special issue: Sudden cardiac death ; Gesehen am 08.01.2024
• Titel Quelle: Enthalten in: Journal of Clinical Medicine
• Ort Quelle: Basel : MDPI, 2012
• Jahr Quelle: 2022
• Band/Heft Quelle: 11(2022), 11, Artikel-ID 2987, Seite 1-20
• ISSN Quelle: 2077-0383
• DOI: doi:10.3390/jcm11112987
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: biomarkers
• Sach-SW: cardiac troponin I
• Sach-SW: coronary artery disease
• Sach-SW: sudden cardiac death
• Sach-SW: ventricular tachyarrhythmias
• K10plus-PPN: 1877423556

Abstract

Besides the diagnostic role in acute myocardial infarction, cardiac troponin I levels (cTNI) may be increased in various other clinical conditions, including heart failure, valvular heart disease and sepsis. However, limited data are available regarding the prognostic role of cTNI in the setting of ventricular tachyarrhythmias. Therefore, the present study sought to assess the prognostic impact of cTNI in patients with ventricular tachyarrhythmias (i.e., ventricular tachycardia (VT) and fibrillation (VF)) on admission. A large retrospective registry was used, including all consecutive patients presenting with ventricular tachyarrhythmias from 2002 to 2015. The prognostic impact of elevated cTNI levels was investigated for 30-day all-cause mortality (i.e., primary endpoint) using Kaplan-Meier, receiver operating characteristic (ROC), multivariable Cox regression analyses and propensity score matching. From a total of 1104 patients with ventricular tachyarrhythmias and available cTNI levels on admission, 46% were admitted with VT and 54% with VF. At 30 days, high cTNI was associated with the primary endpoint (40% vs. 22%; log rank p = 0.001; HR = 2.004; 95% CI 1.603-2.505; p = 0.001), which was still evident after multivariable adjustment and propensity score matching (30% vs. 18%; log rank p = 0.003; HR = 1.729; 95% CI 1.184-2.525; p = 0.005). Significant discrimination of the primary endpoint was especially evident in VT patients (area under the curve (AUC) 0.734; 95% CI 0.645-0.823; p = 0.001). In contrast, secondary endpoints, including all-cause mortality at 30 months and a composite arrhythmic endpoint, were not affected by cTNI levels. The risk of cardiac rehospitalization was lower in patients with high cTNI, which was no longer observed after propensity score matching. In conclusion, high cTNI levels were associated with increased risk of all-cause mortality at 30 days in patients presenting with ventricular tachyarrhythmias.