N-Terminal Pro-Bnp (NT-ProBNP) and High Sensitive Troponin Levels in Patients with Ischemic Dilated Cardiomyopathy and Idiopathic Dilated Cardiomyopathy

Background: The brain-type natriuretic peptides (BNP) and troponins levels can be used for the risk stratification of patients presenting with acute myocardial infarctions. Elevated levels of N-terminal pro-brain natriuretic peptide (NT-ProBNP) can be seen in patients with heart failure (HF) and atrial fibrillation. Objectives: The aim is to evaluate the NT-ProBNP levels and high-sensitive troponin-T (Trop T-HS) levels in patients with ischemic and nonischemic HF and to analyze its association with prognosis. Methods: This prospective observational study was conducted in a tertiary Centre over a period of 2 years. We analyzed NT-ProBNP and Trop T-HS levels of patients with HF, who were admitted to our cardiac intensive care unit. Patients with acute coronary syndrome, myocarditis, and renal failure were excluded from the study. The study population consists of 130 patients, of which 90 patients with ischemic dilated cardiomyopathy (ISDCM) and 40 patients with idiopathic dilated cardiomyopathy (IDCM). They belonged to the New York Heart Association functional classes 3 and 4. The diagnosis was made with the help of a coronary angiogram and transthoracic echocardiogram. We analyzed the NT-ProBNP levels and Trop T-HS of both groups of patients. Results: Males were predominant in both groups, i.e., 70 (77.8%) in the ISDCM patients and 26 (65%) in the IDCM patients. The NT-ProBNP levels were significantly higher among patients with ISDCM compared to patients with (IDCM) dilated cardiomyopathy (8648 ± 6207 pg/mL vs. 3100 ± 2906 pg/mL); P = 0.0008. We analyzed the NT-ProBNP levels of the survivors and nonsurvivors in each group separately. We found that there were significant differences in the levels of NT-ProBNP in the survivors and nonsurvivors in the ISDCM group (7061 ± 3663 vs. 18035 ± 4667 pg/mL); P = 0.0004. However, there was no significant difference between the survivors and nonsurvivors of IDCM patients (4701 ± 737 vs. 6821 ± 1212 pg/mL); P = 0.07. Like the previous analysis, higher levels of Trop T-HS levels were found in patients with ISDCM group compared with IDCM group (26.6 ± 8.5 ng/L vs. 16.3 ± 3.4 ng/L); P = 0.0002. There was also a significant raise of Trop T-HS in the nonsurvivors in the ISDCM group compared to the survivors (28.9 ± 16.3 vs. 65.5 ± 17.0 ng/L): P = 0.0003. Conclusion: In this study, we found that HF patients who were admitted with higher levels of NT-ProBNP and Trop T-HS had a poor prognosis.