Iraqi Postgraduate Medical Journal

Abstract

ABSTRACT:
BACKGROUND:
Cardiac troponins provide diagnostic and prognostic information in acute coronary syndromes, but their role in acute decompensated heart failure is unclear.
OBJECTIVE:
Describe the association between elevated cardiac troponin levels and adverse events in patients hospitalized with acute decompensated heart failure.
METHODS:
Troponin was measured at the time of admission in 340 patients who were hospitalized to Baghdad Teaching Hospital for acute decompensated heart failure between October 2007 and October 2008. A positive troponin test was defined as a cardiac troponin I level of 0.5 ng/mL or higher.
RESULTS:
Overall, 30 patients (8.8%) were positive for troponin. Patients who were positive for troponin had lower systolic blood pressure on admission [138±30 vs. 144±30 mmHg, P value 0.01], a lower left ventricular ejection fraction [mean 33±15 % vs. 38±16%, P value 0.002] and higher in-hospital mortality [3 patients (10%) vs 8 patients (2.58%), P value 0.001] than those who were negative for troponin. The adjusted odds ratio for death in the group of patients with a positive troponin test was 2.45 (95% confidence interval [CI], 2.14 to 2.79; P<0.001) by the Wald test).
CONCLUSION:
In patients with acute decompensated heart failure, a positive cardiac troponin test is associated with higher in-hospital mortality, independently of other predictive variables