Characteristics and prognosis of patients with acute heart failure without troponin determination: The EAHFE-TROPICA3 study

Summary Background The absence of cardiac troponin (cTn) determination in an episode of acute heart failure (AHF) is frequent. The characteristics of these patients are not well known; nor is it known whether they have a better prognosis than patients in whom cTn is determined. Aim The objective of the EAHFE-TROPICA3 study was to analyse the characteristics of patients consulting for AHF in whom cTn was not determined (nocTn), and to evaluate the relationship of cTn determination (wcTn) with patient outcomes. Methods This was an analysis of the multipurpose prospective EAHFE registry of patients with AHF consulting at the emergency departments of 34 Spanish hospitals. Results Data from 8850 patients with AHF were analysed; cTn was not determined in 4216 of these patients (47.6%), who had a lower prevalence of ischaemic heart disease, more frequent use of loop diuretics at baseline, a greater rate of oedema in the acute episode, more frequent history of heart failure, and less use of angiotensin-converting enzyme inhibitors or aldosterone receptor antagonists and beta-blockers at baseline. Compared with the wcTn group, the nocTn group had the same in-hospital mortality (adjusted odds ratio [OR] 1.21, 95% confidence interval [CI] 0.98–1.50), mortality at 30 days (adjusted OR 1.07, 95% CI 0.90–1.28) and reconsultation at 30 days (adjusted OR 0.90, 95% CI 0.80–1.02). Conclusions Patients presenting with AHF with and without cTn determination have different characteristics. These differences are not related to a better prognosis.