High-sensitivity troponin T is associated with poor outcome in adults with pulmonary arterial hypertension due to congenital heart disease

Mark J Schuuring, Annelieke C M J van Riel, Jeroen C Vis, Marielle G Duffels, Jan P van Straalen, S Matthijs Boekholdt, Jan G P Tijssen, Barbara J M Mulder, Berto J Bouma

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

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 ± 12 years) with CHD-PAH, eight patients died during a median follow-up of 5.6 (range 1.6 to 6.8) years. A hsTnT level >0.014 μg/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.

Original languageEnglish
Pages (from-to)520-6
Number of pages7
JournalCongenital Heart Disease
Volume8
Issue number6
DOIs
Publication statusPublished - 2013
Externally publishedYes

Keywords

  • Academic Medical Centers
  • Adult
  • Biomarkers/blood
  • Chi-Square Distribution
  • Eisenmenger Complex/blood
  • Familial Primary Pulmonary Hypertension
  • Female
  • Humans
  • Hypertension, Pulmonary/blood
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain/blood
  • Netherlands
  • Peptide Fragments/blood
  • Predictive Value of Tests
  • Prognosis
  • Proportional Hazards Models
  • Risk Factors
  • Time Factors
  • Troponin T/blood
  • Up-Regulation
  • Ventricular Function, Right

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