High‐sensitivity cardiac troponin T 30 days all‐come mortality in patients with acute heart failure. A Propensity Score‐Matching Analysis Based on the EAHFE Registry. TROPICA4 Study. (15th May 2020)

• Record Type: Journal Article
• Authors: Roset, Alex; Jacob, Javier; Herrero‐Puente, Pablo; Alquézar, Aitor; Martín‐Sanchez, Francisco Javier; Llorens, Pere; Gil, Victor; Cabello, Irene; Richard, Fernando; Garrido, Jose Manuel; Gil, Cristina; Llauger, Lluis; Wussler, Desiree; Mueller, Christian; Miró, Òscar
• Other Names: Fuentes Marta investigator.; Gil Cristina investigator.; Alonso Héctor investigator.; Garmila Pablo investigator.; Rodríguez-Adrada Esther investigator.; Llopis-García Guillermo investigator.; Escoda Rosa investigator.; Xipell Carolina investigator.; Sánchez Carolina investigator.; Gaytan Josep Mª investigator.; Pérez‐Durá María José investigator.; Salvo Eva investigator.; Pavón José investigator.; Noval Antonio investigator.; Torres Murillo José M. investigator.; López‐Grima María Luisa investigator.; Valero Amparo investigator.; Juan-Gómez Mª Angeles investigator.; Aguirre Alfons investigator.; Pedragosa Maria Àngels investigator.; Alonso Maria Isabel investigator.; Ruiz Francisco investigator.; Franco-Sorolla José Miguel investigator.; Diaz Elena investigator.; Mecina Ana Belén investigator.; Tost Josep investigator.; Sánchez Susana investigator.; Carbajosa Virginia investigator.; Piñera Pascual investigator.; Torres-Garate Raquel investigator.; Rizzi Miguel Alberto investigator.; Herrera Sergio investigator.; Haro Antonio investigator.; Cabello Irene investigator.; Dastis Macarena investigator.; Imperiali Claudia Elisabeth investigator.; Roset Alex investigator.; Richard Fernando investigator.; Álvarez Pérez José María investigator.; López-Diez Maria Pilar investigator.; Prieto Belén investigator.; Vázquez Joaquin investigator.; Sánchez-Gonzalez Marta investigator.; Gil-Román José Juan investigator.; Marquina Víctor investigator.; Jiménez Inmaculada investigator.; Hernández Néstor investigator.; López Ana investigator.; Javaloyes Patricia investigator.; Andueza Juan Antonio investigator.; Romero Rodolfo investigator.; Calvache-Arranz Roberto investigator.; Lorca Serralta Mª Teresa investigator.; Calderón Luís Ernesto investigator.; Amores-Arriaga Beatriz investigator.; Sierra-Bergua Beatriz investigator.; Martín-Mojarro Enrique investigator.; Travería Lisette investigator.; Llauger Lluís investigator.; Corominas-LaSalle Gerard investigator.; Agüera-Urbano Carmen investigator.; Gutiérrez-García Ángel investigator.; Ferrer Ester Soy investigator.; Gaya Rut investigator.; Wussler Desiree investigator.; Michou Eleni investigator.; Walter Joan investigator.; Strebel Ivo investigator.; Mueller Christian investigator.;
• Is Part Of: European journal of clinical investigation. Volume 50:Number 6(2020)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2020-05-15
• Subjects: 30‐days mortality -- acute heart failure -- prognosis -- troponin; Pathology -- Periodicals; Medical research -- Periodicals; 616.075
• DOI: 10.1111/eci.13248
• Languages: English
• ISSNs: 0014-2972

Abstract

Abstract: Background: Acute heart failure (AHF) patients with high troponin levels have a worse prognosis. High‐sensitive troponin T (hs‐TnT) has been used as a tool to stratify prognosis in many scales but always as a qualitative and not as a quantitative variable. Objectives: The main objective of this study was to determine the best hs‐TnT cut‐off for prediction of 30‐day all‐cause mortality. Methods: The EAHFE registry, a prospective follow‐up cohort of patients with AHF, was analysed. We performed a propensity score analysis of the optimal hs‐TnT cut‐off point previously determined by receiver operating characteristic (ROC) curve analysis. Results: Of the 13 791 patients in the EAHFE cohort, we analysed 3190 patients in whom hs‐TnT determination was available. The area under the ROC curve for 30‐day all‐cause mortality was 0.70 (CI95% 0.68 to 0.71; P < .001), establishing an optimal cut‐off of hs‐TnT of 35 ng/L. The sensitivity and specificity of this cut‐off were 76.2 and 55.5%, respectively, with a negative predictive value (NPV) of 95.3%. A propensity score was made with 34 variables showing differences based on the cut‐off of 35 ng/L for hs‐TnT. In the analysis of the population obtained with the propensity score, patients with hs‐TnT > 35 ng/L showed a greater 30‐day all‐cause mortality, with a HR of 2.95 (CI95% 1.83‐4.75; P < .001). External validation reported similar results. Conclusions: An hs‐TnT value of 35 ng/L is an adequate cut‐off to evaluate the prediction of 30‐day all‐cause mortality with a NPV of 95.3%.