血清高心肌肌钙蛋白-Ⅰ预测高血压患者心脑血管事件

目的:血清心肌肌钙蛋白Ⅰ(cardiac troponin Ⅰ,cTnI)水平在发生进行性心肌损伤时增高,预示心肌事件的高风险.本文旨在研究是否血清高cTnI水平与无左心室(left ventricular,LV)收缩功能紊乱的高血压(hypertension,HT)患者不良转归相关.方法:收集检测170例无LV收缩功...

Elevated Cardiac Troponin Ⅰ Predicts Cardiovascular or Cerebrovascular Events in Hypertensive Patients

Objective Whether elevated cTnI is associated with cardiovascular or cerebrovascular events in patients with hypertension(HT) without left ventricular(LV) systolic dystunction is not clear.Method We measured cTnI serum level in 170 patients with essential HT without LV systolic dysfunction(LVEF 55%),renal failure,and prior cardiovascular or cerebrovascular diseases.Besides,control group of 40 normal presons was established and following up(45±38)months.Results Level of cTnI was elevated(≥0.04ng/ml) in 15(8.8%) of the 170 patients and in 0(0%) of the 40 normal controls.The rate of diabetes mellitus(DM),the cardiothoracic ratio,serum NT-proBNP value,and LV mass index were significantly higher in patients with than without evevated cTnI(DM,9/15 versus 25/155,P<0.05;cardiothoracic ratio,54.2±4.2 versus 51.4±5.1%,P<0.05;NT-proBNP,109.8±12.2 versus 38.6±4.2pg/ml,P<0.05;LV mass index,222.9±86 versus 153.2±54g/m2,P=0.0001).Kaplan-Meier analysis demonstrated that significantly fewer(P<0.000001) patients with,than without elevated cTnI remained free of events(hospitalization due to cardiovascular or cerebrovascular disease).Stepwise Cox multivariate analysis revealed that elevated cTnT(hazard ratio,6.59,P=0.000001)and smoking(hazard ratio,2.26,P=0.04) were independent predictors of events.Conclusion The present findings indicate that cTnI is a biomarker and useful predictor of future cardiovascular or cerebrovascular events in hypertensive patients.