Clinical Analysis Of Elevated High-sensitivity Troponin T And Its Influencing Factors In Patients With Atrial Fibrillation

Objective: To investigate the detection rates and significantly related influencing factors of high-sensitivity troponin T(hs-cTnT)in hospitalized patients with atrial fibrillation(AF).Method: There were 495 atrial fibrillation patients with noncoronary artery disease who were treated in our hospital and tested hs-cTnT from September 2014 to September 2018.There were 269(54.3%)males and 226(45.7%)females and average age was 69 years(from 33 to 95 years).Demography data,accompanying diseases and risk factors,laboratory indexes and echocardiogram results were collected.Patients were divided into the hscTnT≥0.014ng/ml group and the hs-cTnT < 0.014ng/ml group.Multivariate logistic regression was used to analyze the significant influencing factors of the hs-cTnT increase.Results: Among 495 hospitalized atrial fibrillation patients with non-coronary artery diseases,228(46%)patients had elevated hs-cTnT.There were significant differences in age,heart rate,diabetes,stroke / transient ischemic attack(TIA),NYHA class ≥ II,type of atrial fibrillation,left atrial diameter(LAD),left ventricular ejection fraction(LVEF),estimated glomerular filtration rate(eGFR)between the patients with hs-cTnT≥0.014ng/ml,and those hscTnT<0.014ng/ml(p<0.05).The results,after multivariate logistic regression analysis,showed that age(OR=1.045,95%CI 1.022~1.069,P<0.001),heart rate(OR=1.011,95%CI 1.003 ~ 1.019,P=0.009),diabetes(OR=2.249,95%CI 1.230~4.113,P=0.008),LVEF(OR=0.958,95%CI 0.935~0.983,P=0.001),eGFR(OR=0.982,95%CI 0.969~0.994,P=0.004),NYHA class ≥ II(OR=1.725,95%CI 1.080~2.754,P=0.022)remained as the significantly related influencing factors of elevation of hs-cTnT in atrial fibrillation.Conclusions: Atrial fibrillation can cause myocardial damage and increase troponin,which is related to age,heart rate,diabetes,LVEF,eGFR,NYHA class ≥ II.Older age,faster heart rate,diabetes mellitus,poor cardiac function and eGFR decrease are the main influencing factors of hs-cTnT elevation in patients with atrial fibrillation,which should be paid attention to clinically.