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High sensitivity troponin I as a biomarker for cardiac allograft vasculopathy: Evaluation of diagnostic potential and clinical utility.
Patel, Krishan; Yadalam, Adithya; DeStefano, Robert; Desai, Shivang; Almuwaqqat, Zakaria; Ko, Yi-An; Alras, Zahran; Martini, Mohamed Afif; Ejaz, Kiran; Alvi, Zain; Varounis, Christos; Murtagh, Gillian; Gupta, Divya; Book, Wendy; Quyyumi, Arshed A.
Afiliação
  • Patel K; Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA.
  • Yadalam A; Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA.
  • DeStefano R; Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA.
  • Desai S; Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA.
  • Almuwaqqat Z; Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA.
  • Ko YA; Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
  • Alras Z; Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA.
  • Martini MA; Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA.
  • Ejaz K; Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA.
  • Alvi Z; Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA.
  • Varounis C; Diagnostics Division, Abbott Laboratories, North Chicago, Illinois, USA.
  • Murtagh G; Diagnostics Division, Abbott Laboratories, North Chicago, Illinois, USA.
  • Gupta D; Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA.
  • Book W; Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA.
  • Quyyumi AA; Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA.
Clin Transplant ; 38(1): e15168, 2024 01.
Article em En | MEDLINE | ID: mdl-37882497
INTRODUCTION: Cardiac allograft vasculopathy (CAV) limits long-term survival in heart transplant (HTx) recipients. The use of biomarkers in CAV surveillance has been studied, but none are used in clinical practice. The predictive value of high-sensitivity troponin I (hsTnI) has not been extensively investigated in HTx recipients. METHODS: HTx patients undergoing surveillance coronary angiograms and enrolled in the Emory Cardiovascular Biobank had plasma hsTnI measured. CAV grade was assessed using ISHLT nomenclature. Multivariable cumulative link mixed modeling was performed to determine association between hsTnI level and CAV grade. Patients were followed for adverse outcomes over a median 10-year period. Kaplan-Meier survival analysis and Cox proportional hazard modeling were performed. RESULTS: Three hundred and seventy-two angiograms were analyzed in 156 patients at a median 8.9 years after transplant. hsTnI levels were positively correlated with concurrent CAV grade after adjustment for age, age at transplant, sex, BMI, hypertension, diabetes, hyperlipidemia, estimated glomerular filtration rate, and history of acute cellular rejection (p = .016). In an adjusted Cox proportional hazard model, initial hsTnI level above the median (4.9 pg/mL) remained a predictor of re-transplantation or death (hazard ratio 1.82; 95% confidence interval 1.16-2.90; p = .01). CONCLUSION: An elevated hsTnI level reflects severity of CAV and is associated with poor long-term outcomes in patients with HTx.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Transplante de Coração / Troponina I Limite: Humans Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Transplante de Coração / Troponina I Limite: Humans Idioma: En Ano de publicação: 2024 Tipo de documento: Article