Cardiac troponins and adverse outcomes in European patients with atrial fibrillation: A report from the ESC-EHRA EORP atrial fibrillation general long-term registry.



Vitolo, Marco, Malavasi, Vincenzo L, Proietti, Marco ORCID: 0000-0003-1452-2478, Diemberger, Igor, Fauchier, Laurent, Marin, Francisco, Nabauer, Michael, Potpara, Tatjana S, Dan, Gheorghe-Andrei, Kalarus, Zbigniew
et al (show 6 more authors) (2022) Cardiac troponins and adverse outcomes in European patients with atrial fibrillation: A report from the ESC-EHRA EORP atrial fibrillation general long-term registry. European journal of internal medicine, 99. pp. 45-56.

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Abstract

<h4>Background</h4>Cardiac troponins (cTn) have been reported to be predictors for adverse outcomes in atrial fibrillation (AF), patients, but their actual use is still unclear.<h4>Aim</h4>To assess the factors associated with cTn testing in routine practice and evaluate the association with outcomes.<h4>Methods</h4>Patients enrolled in the ESC-EHRA EORP-AF General Long-Term Registry were stratified into 3 groups according to cTn levels as (i) cTn not tested, (ii) cTn in range (≤99th percentile), (iii) cTn elevated (>99th percentile). The composite outcome of any thromboembolism /any acute coronary syndrome/cardiovascular (CV) death, defined as Major Adverse Cardiovascular Events (MACE) and all-cause death were the main endpoints.<h4>Results</h4>Among 10 445 AF patients (median age 71 years, 40.3% females) cTn were tested in 2834 (27.1%). cTn was elevated in 904/2834 (31.9%) and in-range in 1930/2834 (68.1%) patients. Female sex, in-hospital enrollment, first-detected AF, CV risk factors, history of coronary artery disease, and atypical AF symptoms were independently associated with cTn testing. Elevated cTn were independently associated with a higher risk for MACE (Model 1, hazard ratio [HR] 1.74, 95% confidence interval [CI] 1.40-2.16, Model 2, HR 1.62, 95% CI 1.28-2.05; Model 3 HR 1.76, 95% CI 1.37-2.26) and all-cause death (Model 1, HR 1.45, 95% CI 1.21-1.74; Model 2, HR 1.36, 95% CI 1.12-1.66; Model 3, HR 1.38, 95% CI 1.12-1.71).<h4>Conclusions</h4>Elevated cTn levels were associated with an increased risk of all-cause mortality and adverse CV events. Clinical factors that might enhance the need to rule out CAD were associated with cTn testing.

Item Type: Article
Uncontrolled Keywords: ESC-EHRA EORP-AF Long-Term General Registry Investigators
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User: Symplectic Admin
Date Deposited: 10 Jun 2022 07:12
Last Modified: 14 Feb 2023 02:30
DOI: 10.1016/j.ejim.2022.01.025
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3156085