Open AccessThe Combined Prognostic Potential of Serum High‐Sensitivity Cardiac Troponin I and N‐Terminal pro‐B‐Type Natriuretic Peptide Concentrations in Dogs with Degenerative Mitral Valve Disease
Author(s) -
Hezzell M.J.,
Boswood A.,
Chang Y.M.,
Moonarmart W.,
Souttar K.,
Elliott J.
Publication year - 2012
Publication title -
journal of veterinary internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.356
H-Index - 103
eISSN - 1939-1676
pISSN - 0891-6640
DOI - 10.1111/j.1939-1676.2012.00894.x
Subject(s) - medicine , natriuretic peptide , prospective cohort study , proportional hazards model , troponin , disease , troponin t , cohort , cohort study , survival analysis , cardiology , heart failure , myocardial infarction
Background Identification of factors associated with decreased survival in dogs with degenerative mitral valve disease ( DMVD ) will allow more accurate prognosis. N‐terminal pro‐B‐type natriuretic peptide ( NT ‐pro BNP ) is negatively associated with survival in dogs with DMVD . In human patients, multimarker strategies provide superior risk stratification compared with single markers. Hypothesis High‐sensitivity cardiac troponin I (hscTnI) and other clinical variables will be associated with survival time in dogs with DMVD . Measuring hscTnI and NT ‐pro BNP in combination will be prognostically superior to measurement of either marker alone. The rate of change of these markers will vary according to cause of death. Animals Client‐owned dogs ( n = 202) with DMVD of varying severity and age‐matched healthy control dogs ( n = 30) recruited from first opinion private practice. Methods Prospective cohort study relating clinical variables at enrollment in dogs with DMVD to survival time (all‐cause, cardiac, and noncardiac mortality). Multivariable C ox regression analysis was used to identify factors associated with survival. Measurements were obtained approximately every 6 months. Repeated measures models were constructed to assess changes over time. Results hscTnI, LVEDDN , heart rate, and age were independently associated with decreased survival time (all‐cause mortality). Survival times were shortest in dogs in which both serum hscTnI and NT ‐pro BNP were increased. hscTnI and NT ‐pro BNP increased more rapidly in dogs that died of cardiac disease. Conclusions and Clinical Importance Serum hscTnI has prognostic value in dogs with DMVD . Measurement of NT ‐pro BNP and hscTnI is prognostically superior to measuring either alone. Serial measurement strategies provide additional prognostic information.