Elevated donor cardiac troponin T and procalcitonin indicate two independent mechanisms of early graft failure after heart transplantation
Background: Cardiac troponin T (cTnT) >0.1 μg/l and procalcitonin (PCT) >2 μg/l in the serum of heart donors are predictors of early graft failure after heart transplantation (HTx). The current study investigates the relationship between these two markers and their prognostic value when one or...
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Published in | International journal of cardiology Vol. 92; no. 2; pp. 163 - 167 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
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Elsevier Ireland Ltd
01.12.2003
Elsevier Science |
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Abstract | Background: Cardiac troponin T (cTnT) >0.1 μg/l and procalcitonin (PCT) >2 μg/l in the serum of heart donors are predictors of early graft failure after heart transplantation (HTx). The current study investigates the relationship between these two markers and their prognostic value when one or both of them are elevated.
Methods: Cardiac TnT and PCT were measured in serum from 92 consecutive brain-dead donors accepted for HTx. The donors were retrospectively divided into two groups: group I (
n=78) donors of hearts with good function, group II (
n=14) donors of hearts with early graft failure after transplantation.
Results: There were no correlations between cTnT and PCT values (
r=0.12,
P=0.27). In eight donors in group I one or both markers were elevated. In one donor both markers were above the cut-off levels. In 12 donors (86%) in group II one or both markers were elevated. In two donors both markers were above the cut-off levels and in a further two below. There was no significant interaction between the two markers in either group using a logistic regression model (
P=0.28).
Conclusions: Elevated cTnT and PCT levels in the serum of heart donors were independent prognostic markers of early graft failure. This fact may suggest two different mechanisms of early graft failure: primary myocardial damage and damage related to systemic inflammatory response. The combination of both markers had a higher sensitivity than each parameter on its own. Their use as additional parameters may improve heart donor selection. |
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AbstractList | Background: Cardiac troponin T (cTnT) >0.1 μg/l and procalcitonin (PCT) >2 μg/l in the serum of heart donors are predictors of early graft failure after heart transplantation (HTx). The current study investigates the relationship between these two markers and their prognostic value when one or both of them are elevated.
Methods: Cardiac TnT and PCT were measured in serum from 92 consecutive brain-dead donors accepted for HTx. The donors were retrospectively divided into two groups: group I (
n=78) donors of hearts with good function, group II (
n=14) donors of hearts with early graft failure after transplantation.
Results: There were no correlations between cTnT and PCT values (
r=0.12,
P=0.27). In eight donors in group I one or both markers were elevated. In one donor both markers were above the cut-off levels. In 12 donors (86%) in group II one or both markers were elevated. In two donors both markers were above the cut-off levels and in a further two below. There was no significant interaction between the two markers in either group using a logistic regression model (
P=0.28).
Conclusions: Elevated cTnT and PCT levels in the serum of heart donors were independent prognostic markers of early graft failure. This fact may suggest two different mechanisms of early graft failure: primary myocardial damage and damage related to systemic inflammatory response. The combination of both markers had a higher sensitivity than each parameter on its own. Their use as additional parameters may improve heart donor selection. BACKGROUNDCardiac troponin T (cTnT) >0.1 microg/l and procalcitonin (PCT) >2 microg/l in the serum of heart donors are predictors of early graft failure after heart transplantation (HTx). The current study investigates the relationship between these two markers and their prognostic value when one or both of them are elevated. METHODSCardiac TnT and PCT were measured in serum from 92 consecutive brain-dead donors accepted for HTx. The donors were retrospectively divided into two groups: group I (n=78) donors of hearts with good function, group II (n=14) donors of hearts with early graft failure after transplantation. RESULTSThere were no correlations between cTnT and PCT values (r=0.12, P=0.27). In eight donors in group I one or both markers were elevated. In one donor both markers were above the cut-off levels. In 12 donors (86%) in group II one or both markers were elevated. In two donors both markers were above the cut-off levels and in a further two below. There was no significant interaction between the two markers in either group using a logistic regression model (P=0.28). CONCLUSIONSElevated cTnT and PCT levels in the serum of heart donors were independent prognostic markers of early graft failure. This fact may suggest two different mechanisms of early graft failure: primary myocardial damage and damage related to systemic inflammatory response. The combination of both markers had a higher sensitivity than each parameter on its own. Their use as additional parameters may improve heart donor selection. Cardiac troponin T (cTnT) >0.1 microg/l and procalcitonin (PCT) >2 microg/l in the serum of heart donors are predictors of early graft failure after heart transplantation (HTx). The current study investigates the relationship between these two markers and their prognostic value when one or both of them are elevated. Cardiac TnT and PCT were measured in serum from 92 consecutive brain-dead donors accepted for HTx. The donors were retrospectively divided into two groups: group I (n=78) donors of hearts with good function, group II (n=14) donors of hearts with early graft failure after transplantation. There were no correlations between cTnT and PCT values (r=0.12, P=0.27). In eight donors in group I one or both markers were elevated. In one donor both markers were above the cut-off levels. In 12 donors (86%) in group II one or both markers were elevated. In two donors both markers were above the cut-off levels and in a further two below. There was no significant interaction between the two markers in either group using a logistic regression model (P=0.28). Elevated cTnT and PCT levels in the serum of heart donors were independent prognostic markers of early graft failure. This fact may suggest two different mechanisms of early graft failure: primary myocardial damage and damage related to systemic inflammatory response. The combination of both markers had a higher sensitivity than each parameter on its own. Their use as additional parameters may improve heart donor selection. |
Author | Müller, Christian Hetzer, Roland Loebe, Matthias Jonitz, Britta Sodian, Ralf Potapov, Evgenij V. Ivanitskaia, Ekaterina A. Wagner, Frank D. |
Author_xml | – sequence: 1 givenname: Evgenij V. surname: Potapov fullname: Potapov, Evgenij V. email: potapov@dhzb.de organization: Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353 Berlin, Germany – sequence: 2 givenname: Frank D. surname: Wagner fullname: Wagner, Frank D. organization: Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353 Berlin, Germany – sequence: 3 givenname: Matthias surname: Loebe fullname: Loebe, Matthias organization: Michael E. DeBakey Department of Surgery, Division of Transplantation and Assist Devices, Baylor College of Medicine, Houston, TX, USA – sequence: 4 givenname: Ekaterina A. surname: Ivanitskaia fullname: Ivanitskaia, Ekaterina A. organization: Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353 Berlin, Germany – sequence: 5 givenname: Christian surname: Müller fullname: Müller, Christian organization: Department of Clinical Chemistry, Humboldt University of Berlin, Charité, Virchow Klinikum, Berlin, Germany – sequence: 6 givenname: Ralf surname: Sodian fullname: Sodian, Ralf organization: Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353 Berlin, Germany – sequence: 7 givenname: Britta surname: Jonitz fullname: Jonitz, Britta organization: Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353 Berlin, Germany – sequence: 8 givenname: Roland surname: Hetzer fullname: Hetzer, Roland organization: Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353 Berlin, Germany |
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CitedBy_id | crossref_primary_10_1016_j_transproceed_2012_07_108 crossref_primary_10_1016_j_cpcardiol_2021_100941 crossref_primary_10_1111_jocs_12320 crossref_primary_10_1186_s12879_017_2234_y crossref_primary_10_1097_01_TP_0000119165_32200_1A crossref_primary_10_1016_j_acvd_2017_12_001 crossref_primary_10_1111_ctr_14616 crossref_primary_10_1016_j_bj_2021_10_007 crossref_primary_10_1016_j_ijcard_2007_12_006 crossref_primary_10_1016_j_jhlto_2023_100039 crossref_primary_10_1007_s10741_019_09794_1 crossref_primary_10_1097_AIA_0b013e3182603ead crossref_primary_10_1016_j_healun_2014_02_027 crossref_primary_10_1161_CIRCHEARTFAILURE_112_000165 crossref_primary_10_1016_j_beem_2011_03_003 crossref_primary_10_1016_j_transproceed_2007_02_101 crossref_primary_10_1016_j_ijcard_2006_05_036 crossref_primary_10_1007_s40472_014_0033_6 crossref_primary_10_1016_j_aca_2016_08_007 crossref_primary_10_1161_CIRCHEARTFAILURE_116_003237 crossref_primary_10_1016_j_jss_2018_09_058 crossref_primary_10_1016_j_clinre_2012_01_010 crossref_primary_10_1016_j_jacc_2010_02_055 crossref_primary_10_1016_j_healun_2023_01_005 crossref_primary_10_1097_TXD_0000000000001261 crossref_primary_10_1016_j_ppedcard_2017_06_008 crossref_primary_10_6061_clinics_2021_e3020 crossref_primary_10_1111_j_1527_5299_2005_04178_x crossref_primary_10_1097_TP_0b013e3181b11e5d crossref_primary_10_1161_JAHA_120_018966 crossref_primary_10_1111_ctr_13557 crossref_primary_10_1161_CIRCHEARTFAILURE_111_000358 crossref_primary_10_1016_j_carpath_2005_05_001 crossref_primary_10_1161_CIRCRESAHA_109_194977 crossref_primary_10_1002_ehf2_13471 |
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Keywords | Transplantation Inflammation Ischemia Procalcitonin Cardiac troponin T Graft failure Heart Heart failure Cardiovascular disease Homotransplantation Mechanism Troponin T Treatment Donor Heart disease Surgery Graft Early |
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Snippet | Background: Cardiac troponin T (cTnT) >0.1 μg/l and procalcitonin (PCT) >2 μg/l in the serum of heart donors are predictors of early graft failure after heart... Cardiac troponin T (cTnT) >0.1 microg/l and procalcitonin (PCT) >2 microg/l in the serum of heart donors are predictors of early graft failure after heart... BACKGROUNDCardiac troponin T (cTnT) >0.1 microg/l and procalcitonin (PCT) >2 microg/l in the serum of heart donors are predictors of early graft failure after... |
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SubjectTerms | Adult Biological and medical sciences Brain Death Calcitonin - blood Calcitonin Gene-Related Peptide Cardiac troponin T Cardiology. Vascular system Case-Control Studies Female Glycoproteins - blood Graft failure Graft Survival Heart Heart failure, cardiogenic pulmonary edema, cardiac enlargement Heart Transplantation - physiology Humans Inflammation Ischemia Logistic Models Male Medical sciences Procalcitonin Prognosis Protein Precursors - blood Sensitivity and Specificity Systemic Inflammatory Response Syndrome - blood Time Factors Tissue Donors Transplantation Troponin T - blood |
Title | Elevated donor cardiac troponin T and procalcitonin indicate two independent mechanisms of early graft failure after heart transplantation |
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