National Heart Center Singapore Singapore

Heart, Singapore

National Heart Center Singapore Singapore

Heart, Singapore
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Gohar A.,University Utrecht | Chong J.P.,Cardiovascular Research Institute Singapore Singapore | Liew O.W.,Cardiovascular Research Institute Singapore Singapore | den Ruijter H.,University Utrecht | And 6 more authors.
European Journal of Heart Failure | Year: 2017

Aims: Circulating biomarkers are important in the diagnosis, risk stratification and management of patients with heart failure (HF). Given the current lack of biomarkers in HF with preserved ejection fraction (HFpEF), we aimed to investigate the prognostic performance of the newly developed high-sensitivity (hs) assays for cardiac troponin I (hsTnI) compared with troponin T (hsTnT) for adverse events in HFpEF vs. HF with reduced ejection fraction (HFrEF). Findings in these two HF subgroups were also compared with those in the recently defined HF with mid-range ejection fraction (HFmrEF) subgroup. Methods and results: Both hsTnI and hsTnT were measured in 1096 patients with HFrEF [left ventricular ejection fraction (LVEF) <50%; n=853] or HFpEF (LVEF ≥50%; n=243) enrolled in the Singapore Heart Failure Outcomes and Phenotypes (SHOP) study. Both troponin assays were more strongly associated with the composite endpoint (all-cause mortality or first rehospitalization for HF) in HFpEF than in HFrEF. The hsTnT assay provided the greatest additional prognostic value in HFpEF in comparison with hsTnI and NT-proBNP. TnI was more strongly associated with composite events in men with HFpEF [hazard ratio (HR) 3.33, 95% confidence interval (CI) 1.82-6.09; P<0.001 per standard deviation (SD) increase in log-transformed hsTnI] than in women with HFpEF (HR 1.35, 95% CI 0.94-1.93; P=0.10 per SD increase in log-transformed hsTnI). Conclusions: There is a potential role for the prognostic use of high-sensitivity troponin assays, particularly hsTnT, in men and women with HFpEF. The predictive association of hsTnI with outcome appears strongest in men with HFpEF. © 2017 European Society of Cardiology.


PubMed | Xuzhou Medical College and National Heart Center Singapore Singapore
Type: Journal Article | Journal: International journal of clinical and experimental medicine | Year: 2015

The appropriate assessment of intermediate coronary artery stenosis continues to be a challenge for cardiologists. Several studies have shown that anatomic parameters obtained by intravascular ultrasound (IVUS) and optical coherence tomography (OCT) showed a correlation with fractional flow reserve (FFR) values in identifying hemodynamically severe coronary stenoses. However, the efficacy of IVUS/OCT versus FFR integration in intermediate coronary lesions is still debated. This review will allow for an independent analysis of research data and outlines the diagnostic efficiency of IVUS and OCT derived-anatomical parameters in identifying the hemodynamic significance of an angiographically intermediate stenosis as determined by FFR.

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