Combined measurements of cardiac troponin T and N-terminal pro-brain natriuretic peptide in patients with heart failure

Background To examine the prognostic contribution of combined cardiac troponin T (cTnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with heart failure (CHF) in the absence of acute coronary syndrome. Methods and Results Between July 2001 and March 2002, 71 consecutive patients (mean age = 68.4 +/- 1.4 years, 37 men), hospitalised for heart failure, were studied during hospitalisation and follow up until December 2002. Serum cTnT and NT-proBNP were measured on admission. Actuarial rates of adverse cardiac events, including sudden or CHF death, or rehospitalisation for CHF during follow up were compared with patients grouped according to initial serum cTnT and/or NT-proBNP concentrations. The adverse cardiac event-free rate among the 20 patients with cTnT greater than or equal to 0.01 ng/ml was significantly lower than the 51 patients with cTnT < 0.01 ng/ml (P < 0.05). Similarly, the adverse cardiac event-free rate among the 36 patients with NT-proBNP greater than or equal to 1,357 pg/ml (median) was significantly lower than the 35 patients with NT-proBNP < 1,357pg/ml (P < 0.01). The 16 patients with high concentrations of both cTnT and NT-proBNP had a lower adverse cardiac event-free rate than the 3 1 patients with low cTnT and low NT-proBNP upon commencement of the study (P < 0.005). Conclusion Measurements of serum cTnT and NT-proBNP were reliable prognostic markers of adverse cardiac event in patients with CHF.