Conceptos Categóricos

TROPONINAS CARDIACAS NA AVALIAÇAO PROGNOSTICA E ESTRATIFICAÇAO DE RISCO NA INSUFICIENCIA CARDIACA

TROPONINAS CARDIACAS NA AVALIAÇAO PROGNOSTICA E ESTRATIFICAÇAO DE RISCO NA INSUFICIENCIA CARDIACA

(especial para SIIC © Derechos reservados)
A insuficiência cardíaca é uma síndrome clínica, caracterizada por alta morbidade, mortalidade e diminuição da qualidade de vida. A utilização de biomarcadores de lesão miocárdica altamente sensíveis e específicos (troponinas cardíacas) tem demonstrado utilidade na avaliação prognóstica destes pacientes.
Autor:
Carlos Henrique Del Carlo
Columnista Experto de SIIC

Institución:
Universidade de São Paulo


Artículos publicados por Carlos Henrique Del Carlo
Recepción del artículo
15 de Agosto, 2012
Aprobación
22 de Octubre, 2012
Primera edición
13 de Diciembre, 2012
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
Introdução: As troponinas cardíacas (T e I) foram detectadas na insuficiência cardíaca (IC), tanto na forma crônica avançada, quanto na descompensada, de etiologia isquêmica e não-isquêmica, estando associadas com mau prognóstico. O objetivo deste estudo foi analisar a prevalência das troponinas, mecanismos de liberação e seu valor prognóstico e na estratificação de risco dos pacientes com IC. Resultados: A prevalência das troponinas na IC tem variado amplamente, desde 6.2% até 83.9% (média: 40%), dependendo da sensibilidade do teste e da população estudada. Os mecanismos envolvidos na liberação das troponinas cardíacas na IC permanecem especulativos, mas parecem estar relacionados com os mecanismos de progressão da IC. A presença de lesão miocárdica subclínica, detectada pelas troponinas, é um marcador de mau prognóstico na IC. Diferentes estratégias de detecção das troponinas na IC: determinação única, grau de elevação pela faixa de valores, medida seriada e associação com outros biomarcadores, são formas simples e confiável para avaliação prognostica e estratificação de risco desses pacientes. Conclusão: A detecção das troponinas é um marcador de mau prognóstico na IC. A abordagem terapêutica para redução dos níveis de troponinas na IC abre novas perspectivas para o desenvolvimento de estratégias para prevenção da lesão celular na IC.

Palabras clave
biomarcadores, troponina cardíaca T, troponina cardíaca I, insuficiência cardíaca, prognóstico


Artículo completo

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Abstract
Introduction: Cardiac troponins (T and I) were detected in heart failure (HF), both in advanced chronic form, as in those of decompensated, ischemic and nonischemic etiology, and are associated with poor prognosis. The objective of this study was to analyze the prevalence of troponins, release mechanisms and their value in prognosis and risk stratification of patients with HF.
Results: The prevalence of troponins in HF has varied widely, from 6.2% to 83.9% (average: 40%), depending on the sensitivity of the test and the population studied. The mechanisms involved in the release of cardiac troponins in HF remain speculative, but seem to be related to the mechanisms of progression of HF. The presence of subclinical myocardial damage detected by troponins is a marker of poor prognosis in HF. Different strategies for the detection of troponins in HF: sole determination, the degree of elevation range, serial measurements and association with other biomarkers, are simple and reliable ways to assess prognostic and risk stratification of these patients.
Conclusion: The detection of troponins is a marker of poor prognosis in HF. The therapeutic approach to reducing levels of troponins in HF opens new perspectives for the development of strategies for prevention of cellular injury in heart failure.

Key words
biomarkers, prognosis, heart failure, cardiac troponin T, cardiac troponin I


Clasificación en siicsalud
Artículos originales > Expertos de Iberoamérica >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Cardiología, Diagnóstico por Laboratorio
Relacionadas: Bioquímica, Cuidados Intensivos, Geriatría, Medicina Interna



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Enviar correspondencia a:
Carlos Henrique Del Carlo, Universidade de São Paulo Instituto do Coração Hospital das Clínicas da Faculdade de Medicina, CEP: 02020, Rua Marechal Hermes da Fonseca, 722 – apto 151, San Pablo, Brasil
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