Background Paucity of data is available on the in-hospital and 28-day prognostic value of at-admission highsensitivity troponin T(hs-TnT)level in elderly patients with sepsis admitted to intensive care units.Methods P...Background Paucity of data is available on the in-hospital and 28-day prognostic value of at-admission highsensitivity troponin T(hs-TnT)level in elderly patients with sepsis admitted to intensive care units.Methods Patients aged 65 or older with sepsis or septic shock admitted to geriatric ICU in Guangdong Provincial People’s Hospital between January 2010 and December 2017 were enrolled in the study.Receiver operator characteristic(ROC)curve analysis was performed to evaluate the predictive value of hs-TnT for in-hospital mortality.Multivariate Cox survival regression was used to determine independent risk factor of hs-TnT for 28-day death.Results The in-hospital mortality was 64.4%.According to the receiver operator characteristic(ROC)curve analysis,the cut-off for predicting in-hospital death was 65.2 pg/mL.Patients with elevated hs-TnT had a higher rate of in-hospital mortality(75%vs.53.4%,P<0.001)and 28-day mortality(47.7%vs.27.6%,P<0.001).Multivariate regression showed that lg(hs-TnT)was an independent risk factor for in-hospital death(adjusted HR:1.53,95%CI:1.16-2.01,P=0.03).Kaplan-Meier survival curves showed that elderly patients with at-admission hs-TnT>65.2 pg/mL had a worse outcome than those with hs-TnT<65.2 pg/mL(Log-rank test:17.46,P=0.000).Conclusions In elderly patients with sepsis admitted to intensive care units,elevated hs-TnT level measured upon admission was associated with increased mortality rate.hs-TnT independently contributed to the prediction of 28-day mortality.展开更多
Background:The relationship between the elevation of cardiac troponin and the increase of mortality and hospitalization rate in patients with heart failure with reduced ejection fraction is clear.This study investigat...Background:The relationship between the elevation of cardiac troponin and the increase of mortality and hospitalization rate in patients with heart failure with reduced ejection fraction is clear.This study investigated the association between the extent of elevated levels of high-sensitivity cardiac troponin I(hs-cTnI)and the prognosis in heart failure with preserved ejection fraction patients.Methods:A retrospective cohort study consecutively enrolled 470 patients with heart failure with preserved ejection fraction from September 2014 to August 2017.According to the level of hs-cTnI,the patients were divided into the elevated level group(hs-cTnI>0.034 ng/mL in male and hs-cTnI>0.016 ng/mL in female)and the normal level group.All of the patients were followed up once every 6 months.Adverse cardiovascular events were cardiogenic death and heart failure hospitalization.Results:The mean follow-up period was 36.2±7.9 months.Cardiogenic mortality(18.6%[26/140]vs.1.5%[5/330],P<0.001)and heart failure(HF)hospitalization rate(74.3%[104/140]vs.43.6%[144/330],P<0.001)were significantly higher in the elevated level group.The Cox regression analysis showed that the elevated level of hs-cTnI was a predictor of cardiogenic death(hazard ratio[HR]:5.578,95%confidence interval[CI]:2.995-10.386,P<0.001)and HF hospitalization(HR:3.254,95%CI:2.698-3.923,P<0.001).The receiver operating characteristic curve demonstrated that a sensitivity of 72.6%and specificity of 88.8%for correct prediction of adverse cardiovascular events when a level of hs-cTnI of 0.1305 ng/mL in male and a sensitivity of 70.6%and specificity of 90.2%when a level of hs-cTnI of 0.0755 ng/mL in female were used as the cut-off value.Conclusion:Significant elevation of hs-cTnI(≥0.1305 ng/mL in male and≥0.0755 ng/mL in female)is an effective indicator of the increased risk of cardiogenic death and HF hospitalization in heart failure with preserved ejection fraction patients.展开更多
基金the Project of Administration of Traditional Chinese Medicine of Guangdong Province of China(No.20191050)the Medical Scientific Research Foudation of Guangdong Province of China(No.A2020620)。
文摘Background Paucity of data is available on the in-hospital and 28-day prognostic value of at-admission highsensitivity troponin T(hs-TnT)level in elderly patients with sepsis admitted to intensive care units.Methods Patients aged 65 or older with sepsis or septic shock admitted to geriatric ICU in Guangdong Provincial People’s Hospital between January 2010 and December 2017 were enrolled in the study.Receiver operator characteristic(ROC)curve analysis was performed to evaluate the predictive value of hs-TnT for in-hospital mortality.Multivariate Cox survival regression was used to determine independent risk factor of hs-TnT for 28-day death.Results The in-hospital mortality was 64.4%.According to the receiver operator characteristic(ROC)curve analysis,the cut-off for predicting in-hospital death was 65.2 pg/mL.Patients with elevated hs-TnT had a higher rate of in-hospital mortality(75%vs.53.4%,P<0.001)and 28-day mortality(47.7%vs.27.6%,P<0.001).Multivariate regression showed that lg(hs-TnT)was an independent risk factor for in-hospital death(adjusted HR:1.53,95%CI:1.16-2.01,P=0.03).Kaplan-Meier survival curves showed that elderly patients with at-admission hs-TnT>65.2 pg/mL had a worse outcome than those with hs-TnT<65.2 pg/mL(Log-rank test:17.46,P=0.000).Conclusions In elderly patients with sepsis admitted to intensive care units,elevated hs-TnT level measured upon admission was associated with increased mortality rate.hs-TnT independently contributed to the prediction of 28-day mortality.
文摘Background:The relationship between the elevation of cardiac troponin and the increase of mortality and hospitalization rate in patients with heart failure with reduced ejection fraction is clear.This study investigated the association between the extent of elevated levels of high-sensitivity cardiac troponin I(hs-cTnI)and the prognosis in heart failure with preserved ejection fraction patients.Methods:A retrospective cohort study consecutively enrolled 470 patients with heart failure with preserved ejection fraction from September 2014 to August 2017.According to the level of hs-cTnI,the patients were divided into the elevated level group(hs-cTnI>0.034 ng/mL in male and hs-cTnI>0.016 ng/mL in female)and the normal level group.All of the patients were followed up once every 6 months.Adverse cardiovascular events were cardiogenic death and heart failure hospitalization.Results:The mean follow-up period was 36.2±7.9 months.Cardiogenic mortality(18.6%[26/140]vs.1.5%[5/330],P<0.001)and heart failure(HF)hospitalization rate(74.3%[104/140]vs.43.6%[144/330],P<0.001)were significantly higher in the elevated level group.The Cox regression analysis showed that the elevated level of hs-cTnI was a predictor of cardiogenic death(hazard ratio[HR]:5.578,95%confidence interval[CI]:2.995-10.386,P<0.001)and HF hospitalization(HR:3.254,95%CI:2.698-3.923,P<0.001).The receiver operating characteristic curve demonstrated that a sensitivity of 72.6%and specificity of 88.8%for correct prediction of adverse cardiovascular events when a level of hs-cTnI of 0.1305 ng/mL in male and a sensitivity of 70.6%and specificity of 90.2%when a level of hs-cTnI of 0.0755 ng/mL in female were used as the cut-off value.Conclusion:Significant elevation of hs-cTnI(≥0.1305 ng/mL in male and≥0.0755 ng/mL in female)is an effective indicator of the increased risk of cardiogenic death and HF hospitalization in heart failure with preserved ejection fraction patients.
