High-sensitivity troponin T, NT-proBNP and glomerular filtration rate: A multimarker strategy for risk stratification in chronic heart failure

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Fältnamn	Indikatorer	Metadata
000		06680naa a2200685 4500
001		oai:DiVA.org:uu-374939
003		SwePub
008		190124s2019 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
024	7	a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3749392 URI
024	7	a https://doi.org/10.1016/j.ijcard.2018.10.0792 DOI
040		a (SwePub)uu
041		a engb eng
042		9 SwePub
072	7	a ref2 swepub-contenttype
072	7	a art2 swepub-publicationtype
100	1	a Aimo, Albertou Scuola Super Sant Anna, Pisa, Italy4 aut
245	1 0	a High-sensitivity troponin T, NT-proBNP and glomerular filtration rate :b A multimarker strategy for risk stratification in chronic heart failure
264	1	b Elsevier BV,c 2019
338		a print2 rdacarrier
520		a Background: In a recent individual patient data meta-analysis, high-sensitivity troponin T (hs-TnT) emerged as robust predictor of prognosis in stable chronic heart failure (HF). In the same population, we compared the relative predictive performances of hs-TnT, N-terminal fraction of pro-B-type natriuretic peptide (NT-proBNP), hs-C-reactive protein (hs-CRP), and estimated glomerular filtration rate (eGFR) for prognosis.Methods and results: 9289 patients (66 ± 12 years, 77% men, 85% LVEF <40%, 60% ischemic HF) were evaluated over a 2.4-year median follow-up. Median eGFR was 58 mL/min/1.73 m2 (interquartile interval 46–70; n = 9220), hs-TnT 16 ng/L (8–20; n = 9289), NT-proBNP 1067 ng/L (433–2470; n = 8845), and hs-CRP 3.3 mg/L (1.4–7.8; n = 7083). In a model including all 3 biomarkers, only hs-TnT and NT-proBNP were independent predictors of all-cause and cardiovascular mortality and cardiovascular hospitalization. hs-TnT was a stronger predictor than NT-proBNP: for example, the risk for all-cause death increased by 54% per doubling of hs-TnT vs. 24% per doubling of NT-proBNP. eGFR showed independent prognostic value from both hs-TnT and NT-proBNP. The best hs-TnT and NT-proBNP cut-offs for the prediction of all-cause death increased progressively with declining renal function (eGFR ≥ 90: hs-TnT 13 ng/L and NT-proBNP 825 ng/L; eGFR < 30: hs-TnT 40 ng/L and NT-proBNP 4608 ng/L). Patient categorization according to these cut-offs effectively stratified patient prognosis across all eGFR classes.Conclusions: hs-TnT conveys independent prognostic information from NT-proBNP, while hs-CRP does not. Concomitant assessment of eGFR may further refine risk stratification. Patient classification according to hs-TnT and NT-proBNP cut-offs specific for the eGFR classes holds prognostic significance.
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Kardiologi0 (SwePub)302062 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Cardiac and Cardiovascular Systems0 (SwePub)302062 hsv//eng
653		a Heart failure
653		a Prognosis
653		a Renal function
653		a Troponin
700	1	a Januzzi, James L.,c Jru Massachusetts Gen Hosp, Harvard Clin Res Inst, Boston, MA USA4 aut
700	1	a Vergaro, Giuseppeu Scuola Super Sant Anna, Pisa, Italy; Fdn Toscana G Monasterio, Pisa, Italy4 aut
700	1	a Ripoli, Andreau Fdn Toscana G Monasterio, Pisa, Italy4 aut
700	1	a Latini, Robertou IRCCS Ist Ric Farmacol Mario Negri, Dept Cardiovasc Res, Milan, Italy4 aut
700	1	a Masson, Sergeu IRCCS Ist Ric Farmacol Mario Negri, Dept Cardiovasc Res, Milan, Italy4 aut
700	1	a Magnoli, Michelau IRCCS Ist Ric Farmacol Mario Negri, Dept Cardiovasc Res, Milan, Italy4 aut
700	1	a Anand, Inder S.u Univ Minnesota, Div Cardiovasc Med, Minneapolis, MN USA; VA Med Ctr, Dept Cardiol, Minneapolis, MN USA4 aut
700	1	a Cohn, Jay Nu Univ Minnesota, Div Cardiovasc Med, Minneapolis, MN USA4 aut
700	1	a Tavazzi, Luigiu ES Hlth Sci Fdn, GVM Hosp Care & Res, Cotignola, Italy4 aut
700	1	a Tognoni, Gianniu IRCCS Ist Ric Farmacol Mario Negri, Dept Cardiovasc Res, Milan, Italy4 aut
700	1	a Gravning, Jørgenu Oslo Univ Hosp, Dept Cardiol, Oslo, Norway; Univ Oslo, Ctr Heart Failure Res, Oslo, Norway4 aut
700	1	a Ueland, Thoru Oslo Univ Hosp, Res Inst Internal Med, Rikshosp, Oslo, Norway; Univ Oslo, Fac Med, Oslo, Norway; Univ Tromso, KG Jebsen Thrombosis Res & Expertise Ctr, Tromso, Norway4 aut
700	1	a Nymo, Ståle Hu Oslo Univ Hosp, Res Inst Internal Med, Rikshosp, Oslo, Norway4 aut
700	1	a Rocca, Hans-Peter Brunner-Lau Maastricht Univ, Med Ctr, Dept Cardiol, Maastricht, Netherland4 aut
700	1	a Bayes-Genis, Antoniu Hosp Badalona Germans Trias & Pujol, Barcelona, Spain4 aut
700	1	a Lupón, Josepu Hosp Badalona Germans Trias & Pujol, Barcelona, Spain4 aut
700	1	a de Boer, Rudolf A.u Univ Med Ctr Groningen, Groningen, Netherlands4 aut
700	1	a Yoshihisa, Akiomiu Fukushima Med Univ, Dept Cardiovasc Med, Fukushima, Japan4 aut
700	1	a Takeishi, Yasuchikau Fukushima Med Univ, Dept Cardiovasc Med, Fukushima, Japan4 aut
700	1	a Egstrup, Michaelu Copenhagen Univ Hosp, Dept Cardiol, Rigshosp, Copenhagen, Denmark4 aut
700	1	a Gustafsson, Idau Copenhagen Univ Hosp, Dept Cardiol, Rigshosp, Copenhagen, Denmark4 aut
700	1	a Gaggin, Hanna K.u Massachusetts Gen Hosp, Harvard Clin Res Inst, Boston, MA USA4 aut
700	1	a Eggers, Kai M.,d 1962-u Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi4 aut0 (Swepub:uu)kaieg561
700	1	a Huber, Kurtu Wilhelminenspital Stadt Wien, Fac Internal Med, Vienna, Austria; Sigmund Freud Univ, Med Sch, Vienna, Austria4 aut
700	1	a Tentzeris, Ioannisu Wilhelminenspital Stadt Wien, Fac Internal Med, Vienna, Austria; Sigmund Freud Univ, Med Sch, Vienna, Austria4 aut
700	1	a Wilson Tang, W. H.u Cleveland Clin, Heart & Vasc Inst, Cleveland, OH USA4 aut
700	1	a Grodin, Justin Lu Univ Texas Southwestern Med Ctr Dallas, Dept Internal Med, Div Cardiol, Dallas, TX USA4 aut
700	1	a Passino, Claudiou Scuola Super Sant Anna, Pisa, Italy; Fdn Toscana G Monasterio, Pisa, Italy4 aut
700	1	a Emdin, Micheleu Scuola Super Sant Anna, Pisa, Italy; Fdn Toscana G Monasterio, Pisa, Italy4 aut
710	2	a Scuola Super Sant Anna, Pisa, Italyb Massachusetts Gen Hosp, Harvard Clin Res Inst, Boston, MA USA4 org
773	0	t International Journal of Cardiologyd : Elsevier BVg 277, s. 166-172q 277<166-172x 0167-5273x 1874-1754
856	4	u https://pure.rug.nl/ws/files/78167601/biomarkers_prognosis_M214_01.pdf
856	4 8	u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-374939
856	4 8	u https://doi.org/10.1016/j.ijcard.2018.10.079

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