Cardiac Troponin T and NT-proBNP for Prediction of 30-Day Readmission or Death in Patients with Acute Dyspnea: Data from the Akershus Cardiac Examination 2 Study

• Published in: Cardiology Vol. 148; no. 6; pp. 506 - 516
• Main Authors: Bhatnagar, Rahul, Berge, Kristian, Røysland, Ragnhild, Høiseth, Arne Didrik, Brynildsen, Jon, Christensen, Geir, Omland, Torbjørn, Røsjø, Helge, Lyngbakken, Magnus Nakrem
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland 2023
• Subjects: Biomarkers; Cardiovascular Biomarkers: Research Article; Dyspnea; Heart Failure - diagnosis; Humans; Natriuretic Peptide, Brain; Patient Readmission; Peptide Fragments; Prognosis; Troponin T; Acute dyspnea; Heart Failure; Readmission; N-terminal pro-B-type natriuretic peptide; Cardiac troponin T
• ISSN: 0008-6312; 1421-9751
• DOI: 10.1159/000533266

Introduction: N-terminal pro-B-type natriuretic peptide (NT-proBNP) and cardiac troponin T (cTnT) measurements are recommended in patients with acute dyspnea. We aimed to assess the prognostic merit of cTnT compared to NT-proBNP for 30-day readmission or death in patients hospitalized with acute dyspnea. Methods: We measured cTnT and NT-proBNP within 24 h in 314 patients hospitalized with acute dyspnea and adjudicated the cause of the index admission. Time to first event of readmission or death ≤30 days after hospital discharge was recorded, and cTnT and NT-proBNP measurements were compared head-to-head. Results: Patients who died (12/314) or were readmitted (71/314) within 30 days had higher cTnT concentrations (median: 32.6, Q1–Q3: 18.4–74.2 ng/L vs. median: 19.4, Q1–Q3: 8.4–36.1 ng/L; p for comparison <0.001) and NT-proBNP concentrations (median: 1,753.6, Q1–Q3: 464.2–6,862.0 ng/L vs. median 984, Q1–Q3 201–3,600 ng/L; for comparison p = 0.027) compared to patients who survived and were not readmitted. cTnT concentrations were associated with readmission or death within 30 days after discharge both in the total cohort (adjusted hazard ratio [aHR]: 1.64, 95% confidence interval [CI]: 1.30–2.05) and in patients with heart failure (HF) (aHR: 1.58, 95% CI: 1.14–2.18). In contrast, NT-proBNP concentrations were not associated with short-term events, neither in the total cohort (aHR: 1.10, 95% CI: 0.94–1.30) nor in patients with adjudicated HF (aHR: 1.06, 95% CI: 0.80–1.40). Conclusion: cTnT concentrations are associated with 30-day readmission or death in patients hospitalized with acute dyspnea, as well as in patients adjudicated HF.