Archives of Cardiovascular Diseases   2016 年 109 卷 3 期

2016.03.01

High-sensitivity cardiac troponin is the most specific and sensitive biomarker of myocardial injury. However, no study has investigated whether the early concentration of high-sensitivity cardiac troponin is increased or is of value in predicting short-Term prognosis in patients with type-A acute aortic dissection (AAD) in the emergency department. Aims. - To measure the high-sensitivity cardiac troponin T (hs-TnT) concentration in patients with type-A AAD upon hospital admission, and to assess its value in predicting short-Term prognosis. Methods. - We enrolled consecutive patients with type-A AAD. Blood samples were col-lected on admission; hs-TnT concentrations were measured on the Elecsys 2010 system.High-sensitivity C-reactive protein (hs-CRP), D-dimer and other biochemical indicators weremeasured. Patients were divided into two groups according to hs-TnT concentration on admis-sion (> or ?‰? 0.014 ng/mL).Results. - More than half (61.2%) of the 103 included patients had an hs-TnT concentration?‰? 0.014 ng/mL. hs-TnT concentrations were significantly higher in those who died comparedwith survivors (0.292 ?± 0.516 vs. 0.069 ?± 0.154 ng/mL; P = 0.003). Multivariable Cox regressionanalysis suggested that hs-TnT is an independent factor for predicting in-hospital mortalityrisk (odds ratio: 2.202, 95% confidence interval: 1.111-4.367; P = 0.024). Kaplan-Meier curvesrevealed a significant increase in hospital mortality in the hs-TnT(+) group compared with thehs-TnT(-) group (P = 0.021). When hs-TnT was ?‰? 0.042 ng/mL, the sensitivity and specificity inpredicting hospital short-Term mortality were 70.8% and 76.4%, respectively.Conclusions. - Our study suggests that hs-TnT concentration could be used as an earlybiomarker for the risk stratification of patients with type-A AAD in the emergency depart-ment; the relationship between hs-TnT concentration and long-Term prognosis needs furtherinvestigation.