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Prognostic Utility of Troponin I and N Terminal-ProBNP among Patients with Heart Failure due to Non-Ischemic Cardiomyopathy and Important Correlations

[ Vol. 17 , Issue. 2 ]

Author(s):

Tuoyo O. Mene-Afejuku*, Carissa Dumancas, Adedoyin Akinlonu, Olatunde Ola, Eder H. Cativo, Shushan Veranyan, Persio D. Lopez, Kwon S. Kim, Gerald Pekler, Savi Mushiyev and Ferdinand Visco   Pages 94 - 103 ( 10 )

Abstract:


Background: Heart Failure (HF) is accompanied by a high cost of care and gloomy prognosis despite recent advances in its management. Therefore, efforts to minimize HF rehospitalizations is a major focus of several studies.

Methods: We conducted a retrospective cohort study of 140 patients 18 years and above who had baseline clinical parameters, echocardiography, NT-ProBNP, troponin I and other laboratory parameters following a 3-year electronic medical record review. Patients with coronary artery disease, preserved ejection fraction, pulmonary embolism, cancer, and end-stage renal disease were excluded.

Results: Of the 140 patients admitted with HF with reduced Ejection Fraction (HFrEF) secondary to non-ischemic cardiomyopathy, 15 were re-hospitalized within 30 days of discharge while 42 were rehospitalized within 6 months after discharge for decompensated HF. Receiver operating characteristic (ROC) cutoff points were obtained for NT-ProBNP at 5178 pg/ml and serum troponin I at 0.045 ng/ml. After Cox regression analysis, patients with HFrEF who had higher hemoglobin levels had reduced odds of re-hospitalization (p = 0.007) within 30 days after discharge. NT-ProBNP and troponin I were independent predictors of re-hospitalization at 6 months after discharge (p = 0.047 and p = 0.02), respectively, after Cox regression analysis.

Conclusion: Troponin I and NT-ProBNP at admission are the best predictors of re-hospitalization 6 months after discharge among patients with HFrEF. Hemoglobin is the only predictor of 30 -day rehospitalization among HFrEF patients in this study. High-risk patients may require aggressive therapy to improve outcomes.

Keywords:

Heart failure, re-hospitalization, troponin, cardiomyopathy, reduced ejection fraction, hemoglobin.

Affiliation:

Department of Medicine, New York Medical College, Metropolitan Hospital Center, New York, NY, Department of Medicine, New York Medical College, Metropolitan Hospital Center, New York, NY, Department of Medicine, New York Medical College, Metropolitan Hospital Center, New York, NY, Department of Medicine, New York Medical College, Metropolitan Hospital Center, New York, NY, Department of Medicine, New York Medical College, Metropolitan Hospital Center, New York, NY, Department of Medicine, New York Medical College, Metropolitan Hospital Center, New York, NY, Department of Medicine, New York Medical College, Metropolitan Hospital Center, New York, NY, Department of Medicine, New York Medical College, Metropolitan Hospital Center, New York, NY, Department of Medicine, New York Medical College, Metropolitan Hospital Center, New York, NY, Department of Medicine, New York Medical College, Metropolitan Hospital Center, New York, NY, Department of Medicine, New York Medical College, Metropolitan Hospital Center, New York, NY

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