Dokument: Postoperative high-sensitivity troponin T predicts 1-year mortality and days alive and out of hospital after orthotopic heart transplantation

Titel:Postoperative high-sensitivity troponin T predicts 1-year mortality and days alive and out of hospital after orthotopic heart transplantation
URL für Lesezeichen:https://docserv.uni-duesseldorf.de/servlets/DocumentServlet?id=67354
URN (NBN):urn:nbn:de:hbz:061-20241105-115243-0
Kollektion:Publikationen
Sprache:Englisch
Dokumententyp:Wissenschaftliche Texte » Artikel, Aufsatz
Medientyp:Text
Autoren: M'Pembele, René [Autor]
Roth, Sebastian [Autor]
Nucaro, Anthony [Autor]
Stroda, Alexandra [Autor]
Tenge, Theresa [Autor]
Lurati Buse, Giovanna [Autor]
Bönner, Florian [Autor]
Scheiber, Daniel [Autor]
Ballázs, Christina [Autor]
Tudorache, Igor [Autor]
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Dateien vom 05.11.2024 / geändert 05.11.2024
Stichwörter:IMPACT score, Heart transplantation, Risk prediction, Heart failure, Patient-centered outcomes
Beschreibung:Background

Orthotopic heart transplantation (HTX) is the gold standard to treat end-stage heart failure. Numerous risk stratification tools have been developed in the past years. However, their clinical utility is limited by their poor discriminative ability. High sensitivity troponin T (hsTnT) is the most specific biomarker to detect myocardial cell injury. However, its prognostic relevance after HTX is not fully elucidated. Thus, this study evaluated the predictive value of postoperative hsTnT for 1-year survival and days alive and out of hospital (DAOH) after HTX.
Methods

This retrospective cohort study included patients who underwent HTX at the University Hospital Duesseldorf, Germany between 2011 and 2021. The main exposure was hsTnT concentration at 48 h after HTX. The primary endpoints were mortality and DAOH within 1 year after surgery. Receiver operating characteristic (ROC) curve analysis, logistic regression model and linear regression with adjustment for risk index for mortality prediction after cardiac transplantation (IMPACT) were performed.
Results

Out of 231 patients screened, 212 were included into analysis (mean age 55 ± 11 years, 73% male). One-year mortality was 19.7% (40 patients) and median DAOH was 298 days (229–322). ROC analysis revealed strongest discrimination for mortality by hsTnT at 48 h after HTX [AUC = 0.79 95% CI 0.71–0.87]. According to Youden Index, the cutoff for hsTnT at 48 h and mortality was 1640 ng/l. After adjustment for IMPACT score multivariate logistic and linear regression showed independent associations between hsTnT and mortality/DAOH with odds ratio of 8.10 [95%CI 2.99–21.89] and unstandardized regression coefficient of −1.54 [95%CI −2.02 to −1.06], respectively.
Conclusion

Postoperative hsTnT might be suitable as an early prognostic marker after HTX and is independently associated with 1-year mortality and poor DAOH.
Rechtliche Vermerke:Originalveröffentlichung:
M’Pembele, R., Roth, S., Nucaro, A., Stroda, A., Tenge, T., Lurati Buse, G., Bönner, F., Scheiber, D., Ballázs, C., Tudorache, I., Aubin, H., Lichtenberg , A., Huhn-Wientgen, R., & Boeken, U. (2023). Postoperative high-sensitivity troponin T predicts 1-year mortality and days alive and out of hospital after orthotopic heart transplantation. European Journal of Medical Research, 28, Article 16. https://doi.org/10.1186/s40001-022-00978-4
Lizenz:Creative Commons Lizenzvertrag
Dieses Werk ist lizenziert unter einer Creative Commons Namensnennung 4.0 International Lizenz
Fachbereich / Einrichtung:Medizinische Fakultät
Dokument erstellt am:05.11.2024
Dateien geändert am:05.11.2024
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