Division of Cardiovascular Medicine, Sulpizio Cardiovascular Center, UC San Diego, 9452 Medical Center Drive, La Jolla, CA, 92037-7411, USA.
Curr Heart Fail Rep. 2023 Feb;20(1):33-43. doi: 10.1007/s11897-023-00588-z. Epub 2023 Jan 31.
To review the role of cardiac troponin (cTn) for prognosis in acute and chronic heart failure, and for predicting heart failure; and to explore the association between troponin and response to heart failure therapies, with an eye toward a possible role for troponin in a personalized approach to heart failure management, beyond prognosis.
A number of therapies, including the neprilysin inhibitor sacubitril/valsartan and sodium-glucose cotransporter-2 inhibitors, have recently been shown to improve outcomes in heart failure patients. Most studies suggest that these agents improve outcomes regardless of baseline cTn concentration, but have greater absolute benefit among patients with highest cTn and baseline risk. Troponin is prognostic across the heart failure spectrum, but whether it can significantly help with heart failure prevention and with tailoring and guiding heart failure treatments and interventions remains unknown.
评估心肌肌钙蛋白（cTn）在急性和慢性心力衰竭中的预后价值，以及预测心力衰竭的作用；并探讨肌钙蛋白与心力衰竭治疗反应之间的关系，以期肌钙蛋白在心力衰竭管理的个体化方法中发挥作用，而不仅仅是预后。
最近的一些治疗方法，包括脑啡肽酶抑制剂沙库巴曲缬沙坦和钠-葡萄糖共转运蛋白 2 抑制剂，已被证明可改善心力衰竭患者的预后。大多数研究表明，这些药物可改善预后，而与基线 cTn 浓度无关，但在基线风险最高和 cTn 最高的患者中具有更大的绝对获益。肌钙蛋白在心力衰竭谱中具有预后价值，但它是否能显著有助于心力衰竭的预防，以及有助于调整和指导心力衰竭的治疗和干预，目前尚不清楚。
