Key result
Cardiac troponin T >0.04 ng/ml measured within 2 weeks of peripartum cardiomyopathy onset predicted persistent left ventricular dysfunction at 6 months (84.8% vs 31.5%; OR 12.17, 95% CI 4.17-35.57).
Why the study?
Does cardiac troponin T (cTnT) concentration predict persistent left ventricular dysfunction in patients with newly diagnosed peripartum cardiomyopathy?
Cohort (n=106)
Yes
Does cardiac troponin T (cTnT) concentration predict persistent left ventricular dysfunction in patients with newly diagnosed peripartum cardiomyopathy?
Odds Ratio: 12.17 (95% CI 4.17–35.57)
Absolute Event Rate: 84.8% vs 31.5%
p-value: p=0.001
Elevated cardiac troponin T (>0.04 ng/ml) measured within 2 weeks of peripartum cardiomyopathy onset is a strong predictor of persistent left ventricular dysfunction at 6 months.
May aid early risk stratification in peripartum cardiomyopathy; hypothesis-generating pending prospective validation and trials.
OBJECTIVE: To determine whether measurement of cardiac troponin T (cTnT) concentration in newly diagnosed peripartum cardiomyopathy (PPCM) can be used to predict persistent left ventricular dysfunction after a 6-month follow-up. PATIENTS AND METHODS: This was a prospective, multiple-centre clinical trial that studied 106 patients with newly diagnosed PPCM surviving over 6 months. cTnT concentration was measured within 2 weeks of the onset of PPCM. RESULTS: Serum cTnT concentration was negatively correlated with left ventricular ejection fraction (LVEF) at follow-up (LVEF, r = -0.518, p = 0.0001). Analysis by receiver operator characteristic curve yielded an area under the curve of 0.764 (95% CI 0.669 to 0.860, p = 0.0001, vs null hypothesis value 0.5) for cTnT, and a cTnT concentration cut off of >0.04 ng/ml, predicting persistent left ventricular dysfunction with a sensitivity of 54.9% and a specificity of 90.9%. Among 106 recruited patients, there were 33 patients with cTnT concentrations >0.04 ng/ml and 73 patients with cTnT concentrations < or =0.04 ng/ml. After a 6-month follow-up, there was significantly smaller LVEF (35.42% (13.04% vs 50.16% (10.48%, p = 0.0001) and more persistent left ventricular dysfunction (84.8% vs 31.5%, OR = 12.17 (95% CI 4.17 to 35.57), p = 0.001) in patients with cTnT >0.04 ng/ml than in patients with cTnT < or =0.04 ng/ml. CONCLUSION: Serum cTnT concentration measured within 2 weeks of the onset of PPCM was correlated negatively with LVEF at follow-up. This marker offers a simple, quick, inexpensive, non-invasive method for predicting a persistent LVEF of < or =50%. A cTnT concentration of >0.04 ng/ml predicted persistent left ventricular dysfunction with a sensitivity of 54.9% and a specificity of 90.9%.
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Hu et al. (2006) conducted a cohort in Newly diagnosed peripartum cardiomyopathy (PPCM) (n=106). Cardiac troponin T (cTnT) concentration >0.04 ng/ml vs. cTnT concentration ≤0.04 ng/ml was evaluated on Persistent left ventricular dysfunction (OR 12.17, 95% CI 4.17 to 35.57, p=0.001). Cardiac troponin T >0.04 ng/ml measured within 2 weeks of peripartum cardiomyopathy onset predicted persistent left ventricular dysfunction at 6 months (84.8% vs 31.5%; OR 12.17, 95% CI 4.17-35.57).
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