Usefulness of High-Sensitivity Troponin I in Risk Stratification and Final Disposition of Patients with Acute Heart Failure in the Emergency Department: Comparison between HFpEF vs. HFrEF
<i>Background and Objectives:</i> In patients with acute heart failure (AHF), there is no definite evidence on the relationship between high-sensitivity cardiac troponin (hs-cTnI) and the left ventricular ejection fraction (LVEF) comparing the reduced and preserved EF conditions. <i&g...
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MDPI AG
2022-12-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/1/7 |
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| author | Luca Crisanti Gabriele Valli Elisa Cennamo Alessandro Capolino Paolo Fratini Claudio Cesaro Gloria Adducchio Antonio De Magistris Ferdinando Terlizzi Maria Pia Ruggieri Enrico Mirante Claudio Savoriti Kalyarat Sukruang Valentina Valeriano Francesco Rocco Pugliese Francesco Travaglino Salvatore Di Somma |
| author_facet | Luca Crisanti Gabriele Valli Elisa Cennamo Alessandro Capolino Paolo Fratini Claudio Cesaro Gloria Adducchio Antonio De Magistris Ferdinando Terlizzi Maria Pia Ruggieri Enrico Mirante Claudio Savoriti Kalyarat Sukruang Valentina Valeriano Francesco Rocco Pugliese Francesco Travaglino Salvatore Di Somma |
| author_sort | Luca Crisanti |
| collection | DOAJ |
| description | <i>Background and Objectives:</i> In patients with acute heart failure (AHF), there is no definite evidence on the relationship between high-sensitivity cardiac troponin (hs-cTnI) and the left ventricular ejection fraction (LVEF) comparing the reduced and preserved EF conditions. <i>Materials and Methods</i>: Between January and April 2022, we retrospectively analyzed the data from 386 patients admitted to the emergency departments (ED) of five hospitals in Rome, Italy, for AHF. The criteria for inclusion were a final diagnosis of AHF; a cardiac ultrasound and hs-cTnI evaluations in the ED; and age > 18 yrs. We excluded patients with acute coronary syndrome (ACS). Based on echocardiography and hs-cTnI evaluations, the patients were grouped for (1) preserved (HFpEF) or (2) reduced LVEF (HFrEF) and a a) negative (within the normal range value) or b) positive (above the normal range value) of hs-cTnI, respectively. <i>Results</i>: There was a significant negative relationship between a positive test for hs-cTnI and LVEF. When compared to the group with a negative hs-cTnI test, the patients with a positive test, both from the HFpEF and HFrEF subgroups, were significantly more likely to have an adverse outcome, such as being admitted to the intensive care unit (ICU) or dying in the ED. Moreover, a reduced ejection fraction was linked with a final disposition to a higher level of care. <i>Conclusions</i>: In patients admitted to the ED for AHF without ACS, there is a negative relationship between hs-cTnI and a reduced LVEF, although a significant percentage of patients with a preserved LVEF also resulted to have high levels of hs-cTnI. In the absence of ACS, hs-cTnI seems to be a reliable biomarker of myocardial injury in AHF in the ED and should be considered as a risk stratification parameter for these subjects regardless of the left ventricular function. Further larger prospective studies are needed to confirm these preliminary data. |
| first_indexed | 2024-03-09T11:45:22Z |
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| id | doaj.art-4a8a54649b9446c0b766a7d16f93eb07 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-09T11:45:22Z |
| publishDate | 2022-12-01 |
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| series | Medicina |
| spelling | doaj.art-4a8a54649b9446c0b766a7d16f93eb072023-11-30T23:23:03ZengMDPI AGMedicina1010-660X1648-91442022-12-01591710.3390/medicina59010007Usefulness of High-Sensitivity Troponin I in Risk Stratification and Final Disposition of Patients with Acute Heart Failure in the Emergency Department: Comparison between HFpEF vs. HFrEFLuca Crisanti0Gabriele Valli1Elisa Cennamo2Alessandro Capolino3Paolo Fratini4Claudio Cesaro5Gloria Adducchio6Antonio De Magistris7Ferdinando Terlizzi8Maria Pia Ruggieri9Enrico Mirante10Claudio Savoriti11Kalyarat Sukruang12Valentina Valeriano13Francesco Rocco Pugliese14Francesco Travaglino15Salvatore Di Somma16Postgraduate School of Emergency Medicine, Sapienza University of Rome, 00189 Rome, ItalyDepartment of Emergency Medicine, San Giovanni Addolorata Hospital, 00184 Rome, ItalyPostgraduate School of Emergency Medicine, Sapienza University of Rome, 00189 Rome, ItalyPostgraduate School of Emergency Medicine, Sapienza University of Rome, 00189 Rome, ItalyPostgraduate School of Emergency Medicine, Sapienza University of Rome, 00189 Rome, ItalyPostgraduate School of Emergency Medicine, Sapienza University of Rome, 00189 Rome, ItalyPostgraduate School of Emergency Medicine, Sapienza University of Rome, 00189 Rome, ItalyPostgraduate School of Emergency Medicine, Sapienza University of Rome, 00189 Rome, ItalyPostgraduate School of Emergency Medicine, Sapienza University of Rome, 00189 Rome, ItalyDepartment of Emergency Medicine, San Giovanni Addolorata Hospital, 00184 Rome, ItalyDepartment of Emergency Medicine, Sant’Eugenio Hospital, 00144 Rome, ItalyDepartment of Emergency Medicine, Sant’Eugenio Hospital, 00144 Rome, ItalyDepartment of Family Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, ThailandDepartment of Emergency Medicine, Sandro Pertini Hospital, 00157 Rome, ItalyDepartment of Emergency Medicine, Sandro Pertini Hospital, 00157 Rome, ItalyDepartment of Emergency Medicine, University Campus Biomedico of Rome, 00128 Rome, ItalyPostgraduate School of Emergency Medicine, Sapienza University of Rome, 00189 Rome, Italy<i>Background and Objectives:</i> In patients with acute heart failure (AHF), there is no definite evidence on the relationship between high-sensitivity cardiac troponin (hs-cTnI) and the left ventricular ejection fraction (LVEF) comparing the reduced and preserved EF conditions. <i>Materials and Methods</i>: Between January and April 2022, we retrospectively analyzed the data from 386 patients admitted to the emergency departments (ED) of five hospitals in Rome, Italy, for AHF. The criteria for inclusion were a final diagnosis of AHF; a cardiac ultrasound and hs-cTnI evaluations in the ED; and age > 18 yrs. We excluded patients with acute coronary syndrome (ACS). Based on echocardiography and hs-cTnI evaluations, the patients were grouped for (1) preserved (HFpEF) or (2) reduced LVEF (HFrEF) and a a) negative (within the normal range value) or b) positive (above the normal range value) of hs-cTnI, respectively. <i>Results</i>: There was a significant negative relationship between a positive test for hs-cTnI and LVEF. When compared to the group with a negative hs-cTnI test, the patients with a positive test, both from the HFpEF and HFrEF subgroups, were significantly more likely to have an adverse outcome, such as being admitted to the intensive care unit (ICU) or dying in the ED. Moreover, a reduced ejection fraction was linked with a final disposition to a higher level of care. <i>Conclusions</i>: In patients admitted to the ED for AHF without ACS, there is a negative relationship between hs-cTnI and a reduced LVEF, although a significant percentage of patients with a preserved LVEF also resulted to have high levels of hs-cTnI. In the absence of ACS, hs-cTnI seems to be a reliable biomarker of myocardial injury in AHF in the ED and should be considered as a risk stratification parameter for these subjects regardless of the left ventricular function. Further larger prospective studies are needed to confirm these preliminary data.https://www.mdpi.com/1648-9144/59/1/7acute heart failurehigh-sensitivity troponin Ileft ventricular ejection fractionrisk stratificationemergency department |
| spellingShingle | Luca Crisanti Gabriele Valli Elisa Cennamo Alessandro Capolino Paolo Fratini Claudio Cesaro Gloria Adducchio Antonio De Magistris Ferdinando Terlizzi Maria Pia Ruggieri Enrico Mirante Claudio Savoriti Kalyarat Sukruang Valentina Valeriano Francesco Rocco Pugliese Francesco Travaglino Salvatore Di Somma Usefulness of High-Sensitivity Troponin I in Risk Stratification and Final Disposition of Patients with Acute Heart Failure in the Emergency Department: Comparison between HFpEF vs. HFrEF Medicina acute heart failure high-sensitivity troponin I left ventricular ejection fraction risk stratification emergency department |
| title | Usefulness of High-Sensitivity Troponin I in Risk Stratification and Final Disposition of Patients with Acute Heart Failure in the Emergency Department: Comparison between HFpEF vs. HFrEF |
| title_full | Usefulness of High-Sensitivity Troponin I in Risk Stratification and Final Disposition of Patients with Acute Heart Failure in the Emergency Department: Comparison between HFpEF vs. HFrEF |
| title_fullStr | Usefulness of High-Sensitivity Troponin I in Risk Stratification and Final Disposition of Patients with Acute Heart Failure in the Emergency Department: Comparison between HFpEF vs. HFrEF |
| title_full_unstemmed | Usefulness of High-Sensitivity Troponin I in Risk Stratification and Final Disposition of Patients with Acute Heart Failure in the Emergency Department: Comparison between HFpEF vs. HFrEF |
| title_short | Usefulness of High-Sensitivity Troponin I in Risk Stratification and Final Disposition of Patients with Acute Heart Failure in the Emergency Department: Comparison between HFpEF vs. HFrEF |
| title_sort | usefulness of high sensitivity troponin i in risk stratification and final disposition of patients with acute heart failure in the emergency department comparison between hfpef vs hfref |
| topic | acute heart failure high-sensitivity troponin I left ventricular ejection fraction risk stratification emergency department |
| url | https://www.mdpi.com/1648-9144/59/1/7 |
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