Prognostic Utility of Troponin I And N Terminal- PROBNP Among Patients With Heart Failure Due To Non-Ischemic Cardiomyopathy And Important Correlations

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Author(s): Tuoyo O. Mene-Afejuku*, Carissa Dumancas, Adedoyin Akinlonu, Olatunde Ola, Eder H. Cativo, Shushan Veranyan, Persio D. Lopez, Kwon S. Kim, Gerald Pekler, Savi Mushiyev, Ferdinand Visco.

Journal Name: Cardiovascular & Hematological Agents in Medicinal Chemistry

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Abstract:

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 re-hospitalizations 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 re-hospitalized 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, HFrEF patients with 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 re-hospitalization among HFrEF patients in this study. High risk patients may require aggressive therapy to improve outcomes.

Keywords: troponin, heart failure, re-hospitalization

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(E-pub Ahead of Print)
DOI: 10.2174/1871525717666190717160615