AIM To evaluate the prognostic value of cardiac troponin I (cTnI) and Tilburg frailty scale (TFI) in elderly patients with chronic acute heart failure (CHF).
METHODS A total of 280 elderly CHF patients admitted to Renmin Hospital from September 2014 to August 2017 were divided into four groups according to NYHA cardiac function classification, and the cTnI and TFI scores of each group were compared. By adverse cardiovascular events occurrence during the follow-up period, the patients were divided into major adverse cardiovascular events (MACE) group (n = 92) and non-MACE group (n = 188). The patients’ general clinical data, their blood biochemical indexes the day after admittance to hospital and cTnI and TFI scores were collected. COX proportional hazards models were used to analyze the relationship between cTnI and TFI scores and MACE. According to the cTnI under ROC curve and the best threshold TFI scores, the elderly CHF patients were stratified and Kaplan-meier survival analysis was used to analyze the difference of mean time of MACE occurrence between the stratified groups.
RESULTS The scores of cTnI and TFI increased significantly with the increase of NYHA cardiac function grading (P < 0.05). Compared with those in non-MACE group, cTnI and TFI scores in the MACE group were higher, with statistically significant differences (P < 0.05). The area under the ROC curve of cTnI and TFI scores were 0.722 and 0.761, respectively, which had a high diagnostic value. The optimal threshold values were 8.36 ng/mL and 8 points, respectively. COX analysis results showed that cTnI > 8.36 ng/mL and TFI score > 8 were independent risk factors for MACE in elderly CHF patients. Patients were stratified with the optimal critical values of cTnI and TFI scores. Kaplan-meier survival curve analysis showed that the mean survival time of patients with MACE in the low risk group, the middle risk group and the high-risk group was 14.37 months, 9.39 months and 7.29 months, respectively, with statistically significant differences (P < 0.05).
CONCLUSION CTnI and TFI scores of elderly CHF patients increase significantly with increase of cardiac function and they are independent predictors of MACE in elderly CHF patients, with high diagnostic value. The combination of the two could potentially improve 3-year prediction efficiency of MACE in elderly CHF patients, which would have significant clinical importance.
DownLoad: