Profile of patients with acute heart failure and elevated troponin I levels

BACKGROUND: Elevation of troponin I (TnI), a sensitive marker of myocardial cell injury, has been described in a portion of patients with chronic heart failure and acute decompensated heart failure. The proportion and characteristics of patients with TnI elevation in an unselected population with acute left heart failure (AHF) are, however, not known. PATIENTS AND METHODS: One hundred five consecutive patients with AHF as the leading diagnosis were included in the present study. TnI was routinely assessed at admission and 12 h to 24 h later. Patients with TnI 0.5 mug/L or greater (TnI+ group) and TnI less than 0.5 mug/L (TnI- group) were compared from demographic and clinical points of view. RESULTS: TnI elevation was detected in a total of 28 patients with AHF (26.7%). The TnI+ patients had a significantly higher entry Killip stage (P<0.0001), lower time from onset of symptoms (P=0.002), higher baseline heart rate (P=0.003) and creatinine level (P=0.002), and lower body mass index (P=0.03). On the other hand, the TnI+ group did not differ from TnI- patients in demographic and some clinical parameters, such as age, sex, blood pressure, history of coronary artery disease, major electrocardiograph parameters and left ventricular ejection fraction. CONCLUSIONS: TnI elevation was present in a substantial portion of unselected patients with AHF as the leading clinical diagnosis. Moreover, TnI+ patients differed from those with normal TnI in several clinical parameters.