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Risk prediction in stable cardiovascular disease using a single biomarker strategy with high-sensitivity cardiac troponin t compared to the HeartSCORE

Session Poster session 1

Speaker Moritz Biener

Event : ESC Congress 2017

  • Topic : coronary artery disease, acute coronary syndromes, acute cardiac care
  • Sub-topic : Coronary Artery Disease (Chronic)
  • Session type : Poster Session

Authors : M Biener (Heidelberg,DE), E Giannitsis (Heidelberg,DE), M Kuhner (Heidelberg,DE), T Zelniker (Heidelberg,DE), M Mueller-Hennessen (Heidelberg,DE), M Vafaie (Heidelberg,DE), HA Katus (Heidelberg,DE)

Authors:
M. Biener1 , E. Giannitsis1 , M. Kuhner1 , T. Zelniker1 , M. Mueller-Hennessen1 , M. Vafaie1 , H.A. Katus1 , 1University Hospital of Heidelberg, Department of Cardiology - Heidelberg - Germany ,

Citation:
European Heart Journal ( 2017 ) 38 ( Supplement ), 184

Background: Risk stratification of patients with stable cardiovascular disease is a challenge although risk stratifications tools like the HeartSCORE are available.

Methods: The aim of this analysis was to evaluate the prognostic value of high-sensitivity cardiac troponin T (hs-cTnT) compared to the HeartSCORE in the prediciton of all-cause mortality (ACM) and two composite endpoints (ACM, acute myocardial infarction [AMI] and stroke [EP2] and ACM, AMI, stroke and re-hospitalization for acute coronary syndrome [ACS] and decompensated heart failure [DHF,EP3]) in patients with stable cardiovascular disease. Patients were recruited from a low-risk outpatient population presenting for non-secondary and secondary prevention.

Results: In 693 patients with a median follow-up of 796 days we observed 16 deaths, 32 patients with EP2 and 83 patients with EP3. The HeartSCORE performed better in the prediction of ACM in non-secondary prevention compared to secondary prevention (AUC: 0.803 vs. 0.574, p=0.04). In secondary prevention, hs-cTnT outperformed the HeartSCORE in the prediction of ACM (DAUC: 0.256, p=0.02, Figure 1) and EP3 (DAUC: 0.132, p=0.02). In non-secondary prevention, hs-cTnT performed better in the prediciton of ACM (DAUC: 0.164, p=0.02).

Conclusions: Hs-cTnT outperforms the multivariable HeartSCORE in the prediciton of ACM and a composite endpoint in a secondary prevention cohort with stable cardiovascular disease.

Figure 1

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