TY - JOUR
T1 - High-sensitivity troponin T is associated with poor outcome in adults with pulmonary arterial hypertension due to congenital heart disease
AU - Schuuring, Mark J.
AU - van Riel, Annelieke C.M.J.
AU - Vis, Jeroen C.
AU - Duffels, Marielle G.
AU - van Straalen, Jan P.
AU - Boekholdt, S. Matthijs
AU - Tijssen, Jan G.P.
AU - Mulder, Barbara J.M.
AU - Bouma, Berto J.
PY - 2013/11
Y1 - 2013/11
N2 - Objective: Pulmonary arterial hypertension due to congenital heart disease (CHD-PAH) has a poor prognosis. We sought to determine whether the biomarker high-sensitivity troponin T (hsTnT) measured on routine visit at the outpatient clinic is associated with prognosis.Patients: Consecutive adult CHD-PAH (86% Eisenmenger syndrome) patients referred for advanced medical therapy between January 2005 and March 2007 in the Academic Medical Center in Amsterdam. Patients with severe renal impairment were excluded.Main Outcome Measure: The primary outcome was mortality.Results: Of all 31 patients (mean age 45±12years) with CHD-PAH, eight patients died during a median follow-up of 5.6 (range 1.6 to 6.8) years. A hsTnT level >0.014μg/L was the 99th percentile cutoff of the normal distribution and therefore defined as elevated. At baseline, elevated levels of hsTnT were found in eight patients (26%). In univariate Cox regression, hsTnT elevated at baseline, NT-pro-BNP and right ventricular function were determinants of death (P<.05 for all). Patients with elevated levels of hsTnT showed a significantly higher mortality rate as compared to patients with normal hsTnT levels (62% vs. 13%, P=005).Conclusion: Levels of hsTnT were abnormal in a substantial proportion of CHD-PAH patients. A significant inverse relationship was found between hsTnT and survival.
AB - Objective: Pulmonary arterial hypertension due to congenital heart disease (CHD-PAH) has a poor prognosis. We sought to determine whether the biomarker high-sensitivity troponin T (hsTnT) measured on routine visit at the outpatient clinic is associated with prognosis.Patients: Consecutive adult CHD-PAH (86% Eisenmenger syndrome) patients referred for advanced medical therapy between January 2005 and March 2007 in the Academic Medical Center in Amsterdam. Patients with severe renal impairment were excluded.Main Outcome Measure: The primary outcome was mortality.Results: Of all 31 patients (mean age 45±12years) with CHD-PAH, eight patients died during a median follow-up of 5.6 (range 1.6 to 6.8) years. A hsTnT level >0.014μg/L was the 99th percentile cutoff of the normal distribution and therefore defined as elevated. At baseline, elevated levels of hsTnT were found in eight patients (26%). In univariate Cox regression, hsTnT elevated at baseline, NT-pro-BNP and right ventricular function were determinants of death (P<.05 for all). Patients with elevated levels of hsTnT showed a significantly higher mortality rate as compared to patients with normal hsTnT levels (62% vs. 13%, P=005).Conclusion: Levels of hsTnT were abnormal in a substantial proportion of CHD-PAH patients. A significant inverse relationship was found between hsTnT and survival.
KW - Congenital Heart Disease
KW - Pulmonary Arterial Hypertension
KW - Survival
KW - Troponin
UR - https://www.scopus.com/pages/publications/84889570238
U2 - 10.1111/chd.12022
DO - 10.1111/chd.12022
M3 - Article
C2 - 23241414
SN - 1747-079X
VL - 8
SP - 520
EP - 526
JO - Congenital Heart Disease
JF - Congenital Heart Disease
IS - 6
ER -
