Prognostic Value of Combination of Cardiac Troponin T and B-Type Natriuretic Peptide after Initiation of Treatment in Patients with Chronic Heart Failure

Junnichi Ishii, Wei Cui, Fumihiko Kitagawa, Takahiro Kuno, Yuu Nakamura, Hiroyuki Naruse, Yoshihisa Mori, Takashi Ishikawa, Youichi Nagamura, Takeshi Kondo, Hisaji Oshima, Masanori Nomura, Kouji Ezaki, Hitoshi Hishida

Research output: Contribution to journalArticle

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Abstract

Background: Recent studies have suggested that cardiac troponin T (cTnT) and troponin I may detect ongoing myocardial damage involved in the progression of chronic heart failure (CHF). This study was prospectively designed to examine whether the combination of cTnT, a marker for ongoing myocardial damage, and B-type natriuretic peptide (BNP), a marker for left ventricular overload, would effectively stratify patients with CHF after initiation of treatment. Methods: We measured serum cTnT, plasma BNP, and left ventricular ejection fraction (LVEF) on admission for worsening CHF [New York Heart Association (NYHA) functional class III to IV] and 2 months after initiation of treatment to stabilize CHF (n = 100; mean age, 68 years). Results: Mean (SD) concentrations of cTnT [0.023 (0.066) vs 0.063 (0.20) μg/L] and BNP [249 (276) vs 753 (598) ng/L], percentage increased cTnT (>0.01 μg/L; 35% vs 60%), NYHA functional class [2.5 (0.6) vs 3.5 (5)], and LVEF [43 (13)% vs 36 (12)%] were significantly (P <0.01) improved 2 months after treatment compared with admission. During a mean follow-up of 391 days, there were 44 cardiac events, including 12 cardiac deaths and 32 readmissions for worsening CHF. On a stepwise Cox regression analysis, increased cTnT and BNP were independent predictors of cardiac events (P <0.001). cTnT >0.01 μg/L and/or BNP >160 ng/L 2 months after initiation of treatment were associated with increased cardiac mortality and morbidity rates. Conclusion: The combination of cTnT and BNP measurements after initiation of treatment may be highly effective for risk stratification in patients with CHF.

Original languageEnglish
Pages (from-to)2020-2026
Number of pages7
JournalClinical Chemistry
Volume49
Issue number12
DOIs
Publication statusPublished - 01-12-2003

Fingerprint

Troponin T
Brain Natriuretic Peptide
Heart Failure
Stroke Volume
Therapeutics
Troponin I
Morbidity
Mortality
Plasmas
Serum

All Science Journal Classification (ASJC) codes

  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Ishii, Junnichi ; Cui, Wei ; Kitagawa, Fumihiko ; Kuno, Takahiro ; Nakamura, Yuu ; Naruse, Hiroyuki ; Mori, Yoshihisa ; Ishikawa, Takashi ; Nagamura, Youichi ; Kondo, Takeshi ; Oshima, Hisaji ; Nomura, Masanori ; Ezaki, Kouji ; Hishida, Hitoshi. / Prognostic Value of Combination of Cardiac Troponin T and B-Type Natriuretic Peptide after Initiation of Treatment in Patients with Chronic Heart Failure. In: Clinical Chemistry. 2003 ; Vol. 49, No. 12. pp. 2020-2026.
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abstract = "Background: Recent studies have suggested that cardiac troponin T (cTnT) and troponin I may detect ongoing myocardial damage involved in the progression of chronic heart failure (CHF). This study was prospectively designed to examine whether the combination of cTnT, a marker for ongoing myocardial damage, and B-type natriuretic peptide (BNP), a marker for left ventricular overload, would effectively stratify patients with CHF after initiation of treatment. Methods: We measured serum cTnT, plasma BNP, and left ventricular ejection fraction (LVEF) on admission for worsening CHF [New York Heart Association (NYHA) functional class III to IV] and 2 months after initiation of treatment to stabilize CHF (n = 100; mean age, 68 years). Results: Mean (SD) concentrations of cTnT [0.023 (0.066) vs 0.063 (0.20) μg/L] and BNP [249 (276) vs 753 (598) ng/L], percentage increased cTnT (>0.01 μg/L; 35{\%} vs 60{\%}), NYHA functional class [2.5 (0.6) vs 3.5 (5)], and LVEF [43 (13){\%} vs 36 (12){\%}] were significantly (P <0.01) improved 2 months after treatment compared with admission. During a mean follow-up of 391 days, there were 44 cardiac events, including 12 cardiac deaths and 32 readmissions for worsening CHF. On a stepwise Cox regression analysis, increased cTnT and BNP were independent predictors of cardiac events (P <0.001). cTnT >0.01 μg/L and/or BNP >160 ng/L 2 months after initiation of treatment were associated with increased cardiac mortality and morbidity rates. Conclusion: The combination of cTnT and BNP measurements after initiation of treatment may be highly effective for risk stratification in patients with CHF.",
author = "Junnichi Ishii and Wei Cui and Fumihiko Kitagawa and Takahiro Kuno and Yuu Nakamura and Hiroyuki Naruse and Yoshihisa Mori and Takashi Ishikawa and Youichi Nagamura and Takeshi Kondo and Hisaji Oshima and Masanori Nomura and Kouji Ezaki and Hitoshi Hishida",
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Ishii, J, Cui, W, Kitagawa, F, Kuno, T, Nakamura, Y, Naruse, H, Mori, Y, Ishikawa, T, Nagamura, Y, Kondo, T, Oshima, H, Nomura, M, Ezaki, K & Hishida, H 2003, 'Prognostic Value of Combination of Cardiac Troponin T and B-Type Natriuretic Peptide after Initiation of Treatment in Patients with Chronic Heart Failure', Clinical Chemistry, vol. 49, no. 12, pp. 2020-2026. https://doi.org/10.1373/clinchem.2003.021311

Prognostic Value of Combination of Cardiac Troponin T and B-Type Natriuretic Peptide after Initiation of Treatment in Patients with Chronic Heart Failure. / Ishii, Junnichi; Cui, Wei; Kitagawa, Fumihiko; Kuno, Takahiro; Nakamura, Yuu; Naruse, Hiroyuki; Mori, Yoshihisa; Ishikawa, Takashi; Nagamura, Youichi; Kondo, Takeshi; Oshima, Hisaji; Nomura, Masanori; Ezaki, Kouji; Hishida, Hitoshi.

In: Clinical Chemistry, Vol. 49, No. 12, 01.12.2003, p. 2020-2026.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prognostic Value of Combination of Cardiac Troponin T and B-Type Natriuretic Peptide after Initiation of Treatment in Patients with Chronic Heart Failure

AU - Ishii, Junnichi

AU - Cui, Wei

AU - Kitagawa, Fumihiko

AU - Kuno, Takahiro

AU - Nakamura, Yuu

AU - Naruse, Hiroyuki

AU - Mori, Yoshihisa

AU - Ishikawa, Takashi

AU - Nagamura, Youichi

AU - Kondo, Takeshi

AU - Oshima, Hisaji

AU - Nomura, Masanori

AU - Ezaki, Kouji

AU - Hishida, Hitoshi

PY - 2003/12/1

Y1 - 2003/12/1

N2 - Background: Recent studies have suggested that cardiac troponin T (cTnT) and troponin I may detect ongoing myocardial damage involved in the progression of chronic heart failure (CHF). This study was prospectively designed to examine whether the combination of cTnT, a marker for ongoing myocardial damage, and B-type natriuretic peptide (BNP), a marker for left ventricular overload, would effectively stratify patients with CHF after initiation of treatment. Methods: We measured serum cTnT, plasma BNP, and left ventricular ejection fraction (LVEF) on admission for worsening CHF [New York Heart Association (NYHA) functional class III to IV] and 2 months after initiation of treatment to stabilize CHF (n = 100; mean age, 68 years). Results: Mean (SD) concentrations of cTnT [0.023 (0.066) vs 0.063 (0.20) μg/L] and BNP [249 (276) vs 753 (598) ng/L], percentage increased cTnT (>0.01 μg/L; 35% vs 60%), NYHA functional class [2.5 (0.6) vs 3.5 (5)], and LVEF [43 (13)% vs 36 (12)%] were significantly (P <0.01) improved 2 months after treatment compared with admission. During a mean follow-up of 391 days, there were 44 cardiac events, including 12 cardiac deaths and 32 readmissions for worsening CHF. On a stepwise Cox regression analysis, increased cTnT and BNP were independent predictors of cardiac events (P <0.001). cTnT >0.01 μg/L and/or BNP >160 ng/L 2 months after initiation of treatment were associated with increased cardiac mortality and morbidity rates. Conclusion: The combination of cTnT and BNP measurements after initiation of treatment may be highly effective for risk stratification in patients with CHF.

AB - Background: Recent studies have suggested that cardiac troponin T (cTnT) and troponin I may detect ongoing myocardial damage involved in the progression of chronic heart failure (CHF). This study was prospectively designed to examine whether the combination of cTnT, a marker for ongoing myocardial damage, and B-type natriuretic peptide (BNP), a marker for left ventricular overload, would effectively stratify patients with CHF after initiation of treatment. Methods: We measured serum cTnT, plasma BNP, and left ventricular ejection fraction (LVEF) on admission for worsening CHF [New York Heart Association (NYHA) functional class III to IV] and 2 months after initiation of treatment to stabilize CHF (n = 100; mean age, 68 years). Results: Mean (SD) concentrations of cTnT [0.023 (0.066) vs 0.063 (0.20) μg/L] and BNP [249 (276) vs 753 (598) ng/L], percentage increased cTnT (>0.01 μg/L; 35% vs 60%), NYHA functional class [2.5 (0.6) vs 3.5 (5)], and LVEF [43 (13)% vs 36 (12)%] were significantly (P <0.01) improved 2 months after treatment compared with admission. During a mean follow-up of 391 days, there were 44 cardiac events, including 12 cardiac deaths and 32 readmissions for worsening CHF. On a stepwise Cox regression analysis, increased cTnT and BNP were independent predictors of cardiac events (P <0.001). cTnT >0.01 μg/L and/or BNP >160 ng/L 2 months after initiation of treatment were associated with increased cardiac mortality and morbidity rates. Conclusion: The combination of cTnT and BNP measurements after initiation of treatment may be highly effective for risk stratification in patients with CHF.

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AN - SCOPUS:0344514874

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JF - Clinical Chemistry

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