Healey Jeffrey S, Davies Richard F, Smith Stuart J, Davies Ross A, Ooi Daylily S
Division of Cardiology, Ottawa Heart Institute and Department of Medicine, University of Ottawa, Ontario, Canada.
Can J Cardiol. 2003 Mar 31;19(4):383-6.
Troponin T (cTnT) and troponin I (cTnI) are present in the sera of some heart failure (HF) patients and have potential importance as prognostic markers.
To prospectively evaluate the prognostic value of cTnT and cTnI in well-characterized HF patients and clarify their relationship to other clinical markers of HF severity.
cTnT and cTnI were measured in 78 HF patients (45 inpatients, 33 outpatients) who were followed up prospectively for 12 months.
Plasma cTnT (> or =0.02 ng/mL) and cTnI (> or =0.3 ng/mL) were detected in 51% and 46% of patients, respectively. These patients were more likely to be inpatients (70% versus 45% for cTnT, 75% versus 43% for cTnI, P<0.05 for both), have a higher plasma creatinine (153 versus 119 micromol/L for cTnT; 157 versus 118 micromol/L for cTnI, P<0.05) and lower plasma sodium (134 versus 138 mmol/L for both, P<0.05). At 12 months, they were more likely to have died or undergone cardiac transplantation (41% versus 14%, P=0.01 for cTnT; 43% versus 15%, P=0.004 for cTnI). After adjustment for New York Heart Association class, plasma sodium and inpatient status, a significant association with events was still evident for both troponins.
Both cTnT and cTnI are strongly associated with other clinical indicators of HF severity and remain independent predictors of prognosis after adjustment for these factors. These results indicate a potential role for cTnT and cTnI in the clinical management of HF patients.
肌钙蛋白T（cTnT）和肌钙蛋白I（cTnI）存在于部分心力衰竭（HF）患者的血清中，作为预后标志物具有潜在重要性。
前瞻性评估cTnT和cTnI在特征明确的HF患者中的预后价值，并阐明它们与HF严重程度的其他临床标志物之间的关系。
对78例HF患者（45例住院患者，33例门诊患者）进行cTnT和cTnI检测，并对其进行为期12个月的前瞻性随访。
分别在51%和46%的患者中检测到血浆cTnT（≥0.02 ng/mL）和cTnI（≥0.3 ng/mL）。这些患者更有可能是住院患者（cTnT组为70%对45%，cTnI组为75%对43%，两者P<0.05），血浆肌酐水平更高（cTnT组为153对119 μmol/L；cTnI组为157对118 μmol/L，P<0.05），血浆钠水平更低（两组均为134对138 mmol/L，P<0.05）。在12个月时，他们更有可能死亡或接受心脏移植（cTnT组为41%对14%，P=0.01；cTnI组为43%对15%，P=0.004）。在对纽约心脏协会分级、血浆钠和住院状态进行校正后，两种肌钙蛋白与事件之间仍存在显著关联。
cTnT和cTnI均与HF严重程度的其他临床指标密切相关，在对这些因素进行校正后仍是独立的预后预测指标。这些结果表明cTnT和cTnI在HF患者的临床管理中具有潜在作用。
