Cardiac troponins provide diagnostic and prognostic information in acute coronary syndromes, but their role in acute decompensated heart failure is unclear.
Describe the association between elevated cardiac troponin levels and adverse events in patients hospitalized with acute decompensated heart failure.
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.
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).
In patients with acute decompensated heart failure, a positive cardiac troponin test is associated with higher in-hospital mortality, independently of other predictive variables