Prognostic value of troponin I in atrial fibrillation.
Por:
Quesada, A, Lopez-Valero, L, Marcaida-Benito, G, Bello, J, Quesada-Ocete, J, Rubini-Costa, R, Quesada-Ocete, B, Rubini-Puig, R, Ferez-Marti, A, del Moral-Ronda, V, Palanca-Gil, V, de la Guia-Galipienso, F, Lavie, C, Lippi, G and Sanchis-Gomar, F
Publicada:
1 jul 2021
Ahead of Print:
25 feb 2021
Categoría:
Cardiology and cardiovascular medicine
Resumen:
OBJECTIVE: To evaluate whether circulating cardiac troponin I (cTnI) levels are associated with worst outcomes in patients with atrial fibrillation (AF). METHODS: Consecutive patients visiting the emergency room (ER) with a new episode of a previously diagnosed AF or a new diagnosis of AF during ER admission between January 1st, 2010 and December 31st, 2015, were enrolled in the study (n = 2617). After applying exclusion criteria and eliminating repeated episodes, 2013 patients were finally included. Of these, 1080 patients with at least one cTnI measurement in the ER were selected and classified into 4 groups according to cTnI quartiles: Q1 (n = 147) cTnI <10 ng/L (Group 1); Q2 (n = 254): 10-19 ng/L (Group 2); Q3 (n = 409): 20-40 ng/L (Group 3); and Q4 (n = 270): cTnI >40 ng/L (Group 4). The median follow-up period was 47.8 ± 32.8 months. The primary endpoint was all-cause death during the follow-up. RESULTS: A higher mortality was found in group 4 compared with the other groups (58.9% vs. 28.5%, respectively, p < 0.001), along with, hospitalizations (40.4% vs. 30.7%, p = 0.004), and readmissions due to decompensated heart failure (26.7% vs. 2.5%, p = 0.002). The probability of survival without AF recurrences was lower in the Q4 (p = 0.045). Moreover, cTnI levels >40 ng/L (Q4) were an independent risk factor of death (HR, 2.03; 95% CI, 1.64-2.51; p < 0.001). CONCLUSION: The assessment of cTnI at ER admission could be a useful strategy for risk stratification of patients diagnosed with AF by identifying a subgroup with medium-term to long-term increased risk of adverse events and mortality.
Filiaciones:
Quesada, A:
Gen Univ Hosp Consortium Valencia, Arrhythmia Unit, Cardiol Serv, Av Tres Creus 2, Valencia 46014, Spain
Catholic Univ Valencia San Vicente Martir, Sch Med, Valencia, Spain
Lopez-Valero, L:
Catholic Univ Valencia San Vicente Martir, Sch Med, Valencia, Spain
Marcaida-Benito, G:
Gen Univ Hosp Consortium Valencia, Lab Med Serv, Valencia, Spain
Bello, J:
Gen Univ Hosp Consortium Valencia, Arrhythmia Unit, Cardiol Serv, Av Tres Creus 2, Valencia 46014, Spain
Quesada-Ocete, J:
Gen Univ Hosp Consortium Valencia, Arrhythmia Unit, Cardiol Serv, Av Tres Creus 2, Valencia 46014, Spain
Rubini-Costa, R:
Hosp Virgen de las Nieves, Dept Cardiol, Granada, Spain
Quesada-Ocete, B:
Johannes Gutenberg Univ Mainz, Univ Med Ctr, Ctr Cardiol, Dept Cardiol II Electroplaysiol, Mainz, Germany
Rubini-Puig, R:
Gen Univ Hosp Consortium Valencia, Emergency Room Dept, Valencia, Spain
Ferez-Marti, A:
Gen Univ Hosp Consortium Valencia, Lab Med Serv, Valencia, Spain
del Moral-Ronda, V:
Hosp Univ Tarragona Joan XXVM, Dept Cardiol, Tarragona, Spain
Palanca-Gil, V:
Gen Univ Hosp Consortium Valencia, Arrhythmia Unit, Cardiol Serv, Av Tres Creus 2, Valencia 46014, Spain
:
Cardiol Serv Marina Baixa Hosp, Alicante, Spain
Lavie, C:
Univ Queensland, Sch Med, John Ochsner Heart & Vasc Inst, Ochsner Clin Sch, New Orleans, LA USA
Lippi, G:
Univ Verona, Sect Clin Biochem, Verona, Italy
Sanchis-Gomar, F:
Univ Valencia, Dept Physiol, Fac Med, Av Blasco Ibanez 15, Valencia 46010, Spain
INCLIVA Biomed Res Inst, Valencia, Spain
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