Abstract 17981: Prognostic Value of Troponins in Chronic Stable Heart Failure: A Systematic Review
Introduction: Cardiac troponins have become the ‘gold standard’ for diagnosing myocardial infarction, but the prognostic value of different types of troponin in chronic stable heart failure is not very clear. Our objective was to perform a systematic review to investigate the prognostic value of the different type of cardiac troponins (including low and high sensitivity) in chronic stable heart failure.
Methods: Search of three databases, PubMed, The Cochrane Library and Web of Science were made in April 2012. All studies which provided information on prognosis based upon the baseline cardiac troponin elevation in chronic heart failure were included. Studies which investigated acute decompensated heart failure (ADHF) were excluded. Two authors individually reviewed all studies and extracted data on patient and study characteristics along with primary and secondary outcomes.
Results: Sixteen of the 365 abstracts from three databases were finally included for data analysis. Elevated baseline cardiac troponin in patients with chronic stable heart failure was associated with high risk of mortality (HR, 2.85; 95% CI, 2.02 to 4.03) and combined adverse cardiovascular outcome (HR, 2.38; 95% CI, 1.63 to 3.49). Although high sensitivity cardiac troponin was elevated in higher proportion of patients, the point estimate of hazard ratios was higher in high sensitivity cardiac troponin group (HR, 3.19; 95% CI, 1.66 to 6.15) than low sensitivity cardiac troponin group (HR, 2.55; 95% CI, 1.91 to 3.40) suggesting higher risk of mortality, but there was no statistically significant difference among both groups (p=0.54).
Conclusions: Elevated baseline cardiac troponin level identified chronic stable heart failure patients who are at higher risk of mortality and combined adverse cardiovascular outcomes. There was no statistically significant difference between high and low sensitivity cardiac troponins.
- © 2012 by American Heart Association, Inc.