Different expression and prognostic value of troponin in ischemic cardiomyopathy and non-ischemic dilated cardiomyopathy

European Journal of Medical Research

Research

Meng Zhang¹  Junbo Ge²  Yamei Xu²  Jingmin Zhou²  Wei Gao²  Yu Song²  Xueting Han² 

[1] Department of Cardiology, Zhongshan Hospital, Fudan University (Xiamen Branch), Xiamen, China;Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China;National Clinical Research Center for Interventional Medicine, Shanghai, China;

关键词: Heart failure;    Ischemic cardiomyopathy;    Non-ischemic dilated cardiomyopathy;    Cardiac troponin;   

DOI  :  10.1186/s40001-023-01169-5

 received in 2023-02-27, accepted in 2023-06-14,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundEarly risk stratification of patients with ischemic cardiomyopathy (ICM) and non-ischemic dilated cardiomyopathy (NIDCM) may be beneficial for therapies.MethodsWe 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.ResultsA 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.ConclusionThe 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.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

Fig. 3

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