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October 11, 2011Journal of Internal MedicineOpen Access

Sensitive cardiac troponin in the diagnosis and risk stratification of acute heart failure

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Why the study?

Does sensitive cardiac troponin I measurement improve diagnosis and risk stratification for mortality in patients presenting with acute dyspnoea and acute heart failure?

Population

667 consecutive patients presenting to the emergency department with acute dyspnoea, including 377 with…

Comparison

Measurement of sensitive cardiac troponin I… vs Lower strata of s-cTnI and noncardiac causes of…

Design

Cohort, Final diagnosis adjudicated by two independent cardiologists blinded…

Follow-up

median 371 days

Key result

Sensitive cardiac troponin I independently predicted 1-year mortality in acute heart failure (adjusted OR 1.03 per 0.1 μg/L increase, 95% CI 1.02-1.05, P<0.001).

Authors

NANisha ArenjaTRTobias ReichlinBDBeatrice Drexler

Discussion

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Member takes

Overview

May aid mortality risk stratification in acute HF; leaves open whether troponin integration improves outcomes or warrants trials.

Study Design

Type

Observational (n=667)

Structured PICO

Does sensitive cardiac troponin I measurement improve diagnosis and risk stratification for mortality in patients presenting with acute dyspnoea and acute heart failure?

P
Population
667 consecutive patients presenting to the emergency department with acute dyspnoea, including 377 (57%) with adjudicated acute heart failure.
I
Intervention
Measurement of sensitive cardiac troponin I (s-cTnI) stratified into <0.01 μg/L, 0.01-0.027 μg/L, and ≥0.028 μg/L.
C
Comparator
Lower strata of s-cTnI (for prognosis) and noncardiac causes of acute dyspnoea (for diagnosis).
O
Outcome
Diagnosis of acute heart failure and mortality (in-hospital and 1-year).hard clinical

Main Result

Effect estimate: adjusted OR 1.03 (95% CI 1.02-1.05)

p-value: p=<0.001

Sensitive cardiac troponin I is a strong predictor of short- and long-term prognosis in acute heart failure, with detectable levels even within the normal range independently associated with mortality.

Cite This Study

Arenja et al. (2011) conducted an observational in Acute heart failure (n=667). Sensitive cardiac troponin I (s-cTnI) vs. Different strata of s-cTnI levels was evaluated on 1-year mortality (adjusted OR 1.03, 95% CI 1.02-1.05, p=<0.001). Sensitive cardiac troponin I independently predicted 1-year mortality in acute heart failure (adjusted OR 1.03 per 0.1 μg/L increase, 95% CI 1.02-1.05, P<0.001).

synapsesocial.com/papers/6a1459e37b6de318bf59a832https://doi.org/10.1111/j.1365-2796.2011.02469.x
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