Key result
Non-ischemic dilated cardiomyopathy is linked to ~83% lower in-hospital mortality versus ischemic cardiomyopathy.
Why the study?
Early risk stratification of patients with ischemic cardiomyopathy and non-ischemic dilated cardiomyopathy may be beneficial for tailoring therapies.
Does the prognostic value and optimal cutoff of troponin T for in-hospital mortality differ between patients with ischemic cardiomyopathy and non-ischemic dilated cardiomyopathy?
Cohort (n=1,525)
No
Does the prognostic value and optimal cutoff of troponin T for in-hospital mortality differ between patients with ischemic cardiomyopathy and non-ischemic dilated cardiomyopathy?
Troponin T is an independent predictor of in-hospital mortality in both ischemic and non-ischemic dilated cardiomyopathy, but the optimal prognostic cutoff value is significantly higher in ischemic patients.
Answers are grounded in this paper and cite their sources.
NIDCM diagnosis may support etiology-informed short-term risk assessment; leaves open whether etiology-specific models improve troponin-based prognostication.
BACKGROUND: Early risk stratification of patients with ischemic cardiomyopathy (ICM) and non-ischemic dilated cardiomyopathy (NIDCM) may be beneficial for therapies. METHODS: We retrospectively enrolled all patients admitted for acute heart failure (HF) between January 2019 and December 2021 in Zhongshan Hospital Fudan University, dividing them according to etiology (ICM or NIDCM). Cardiac troponin T (TNT) concentration was compared between two groups. Risk factors for positive TNT and in-hospital all-cause mortality were investigated with regression analysis. RESULTS: A total of 1525 HF patients were enrolled, including 571 ICM and 954 NIDCM. The TNT positive patients were not different between the two groups (41.3% in ICM group vs. 37.8% in NIDCM group, P = 0.215). However, the TNT value in ICM group were significantly higher than that in NIDCM group (0.025 (0.015-0.053) vs. 0.020 (0.014-0.041), P = 0.001). NT-proBNP was independently associated with TNT in both ICM and NIDCM group. Although the in-hospital all-cause mortality did not show much difference between the two groups (1.1% vs. 1.9%, P = 0.204), the NIDCM diagnosis was associated with reduced risk of mortality after multiple adjustments (OR 0.169, 95% CI 0.040-0.718, P = 0.016). Other independent risk factors included the level of NT-proBNP (OR 8.260, 95% CI 3.168-21.533, P < 0.001), TNT (OR 8.118, 95% CI 3.205-20.562, P < 0.001), and anemia (OR 0.954, 95% CI 0.931-0.978, P < 0.001). The predictive value of TNT and NT-proBNP for all-cause mortality was similar. However, the best cutoff values of TNT for mortality were different between ICM and NIDCM groups, which were 0.113 ng/mL and 0.048 ng/mL, respectively. CONCLUSION: The TNT level was higher in ICM patient than that in NIDCM patients. TNT was an independent risk factor for in-hospital all-cause mortality for both ICM and NIDCM patients, although the best cutoff value was higher in ICM patients.
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Gao et al. (2023) conducted a cohort in Acute heart failure (Ischemic and Non-ischemic dilated cardiomyopathy) (n=1,525). Non-ischemic dilated cardiomyopathy (NIDCM) vs. Ischemic cardiomyopathy (ICM) was evaluated on In-hospital all-cause mortality (OR 0.169, 95% CI 0.040-0.718, p=0.016). Non-ischemic dilated cardiomyopathy was associated with a significantly reduced risk of in-hospital all-cause mortality compared to ischemic cardiomyopathy after multiple adjustments (OR 0.169).
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