Emergency Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, 08907 Barcelona, Catalonia, Spain.
Emergency Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, 08907 Barcelona, Catalonia, Spain.
Arch Cardiovasc Dis. 2019 Jun-Jul;112(6-7):390-399. doi: 10.1016/j.acvd.2019.02.004. Epub 2019 Apr 20.
The absence of cardiac troponin (cTn) determination in an episode of acute heart failure (AHF) is frequent. The characteristics of these patients are not well known; nor is it known whether they have a better prognosis than patients in whom cTn is determined.
The objective of the EAHFE-TROPICA3 study was to analyse the characteristics of patients consulting for AHF in whom cTn was not determined (nocTn), and to evaluate the relationship of cTn determination (wcTn) with patient outcomes.
This was an analysis of the multipurpose prospective EAHFE registry of patients with AHF consulting at the emergency departments of 34 Spanish hospitals.
Data from 8850 patients with AHF were analysed; cTn was not determined in 4216 of these patients (47.6%), who had a lower prevalence of ischaemic heart disease, more frequent use of loop diuretics at baseline, a greater rate of oedema in the acute episode, more frequent history of heart failure, and less use of angiotensin-converting enzyme inhibitors or aldosterone receptor antagonists and beta-blockers at baseline. Compared with the wcTn group, the nocTn group had the same in-hospital mortality (adjusted odds ratio [OR] 1.21, 95% confidence interval [CI] 0.98-1.50), mortality at 30 days (adjusted OR 1.07, 95% CI 0.90-1.28) and reconsultation at 30 days (adjusted OR 0.90, 95% CI 0.80-1.02).
Patients presenting with AHF with and without cTn determination have different characteristics. These differences are not related to a better prognosis.
在急性心力衰竭（AHF）发作中，经常会出现未检测到心肌肌钙蛋白（cTn）的情况。这些患者的特征尚不清楚；也不知道与检测到 cTn 的患者相比，他们的预后是否更好。
EAHFE-TROPICA3 研究的目的是分析在未检测到 cTn 的 AHF 患者（nocTn）的特征，并评估 cTn 检测（wcTn）与患者结局的关系。
这是一项对 34 家西班牙医院急诊科就诊的 AHF 患者进行的多用途前瞻性 EAHFE 登记研究的分析。
分析了 8850 例 AHF 患者的数据；其中 4216 例（47.6%）未检测到 cTn，这些患者的缺血性心脏病患病率较低，基线时更频繁使用袢利尿剂，急性发作时水肿发生率更高，心力衰竭病史更频繁，基线时血管紧张素转换酶抑制剂或醛固酮受体拮抗剂和β受体阻滞剂的使用率较低。与 wcTn 组相比，nocTn 组的院内死亡率相同（调整后的优势比 [OR] 1.21，95%置信区间 [CI] 0.98-1.50），30 天死亡率（调整后的 OR 1.07，95% CI 0.90-1.28）和 30 天再就诊率（调整后的 OR 0.90，95% CI 0.80-1.02）。
有和没有 cTn 检测的 AHF 患者具有不同的特征。这些差异与更好的预后无关。
