hs-cTnT and NT-ProBNP, rather than unspecified coronary artery disease, may be associated with further decompensation and death in liver cirrhosis.

BACKGROUND

Currently, coronary artery disease (CAD) is very common worldwide, and N-terminal pro-B-type natriuretic peptide (NT-ProBNP) and high-sensitivity cardiac troponin T (hs-cTnT) are major serum biomarkers for cardiac dysfunction. However, the association between unspecified CAD, NT-ProBNP, and hs-cTnT with prognosis of patients with cirrhosis remains unclear.

METHODS

Patients with cirrhosis who were consecutively admitted to the Department of Gastroenterology of our hospital from June 2020 to January 2024 were retrospectively screened. Kaplan-Meier and Nelson-Aalen cumulative risk curves as well as competing risk and Cox regression analyses were used to estimate the associations of unspecified CAD, NT-ProBNP, and hs-cTnT with further decompensation and death, if appropriate.

RESULTS

Overall, 601 cirrhotic patients were included. hs-cTnT>14 ng/L and NT-ProBNP>300 pg/ml, rather than unspecified CAD, were significantly associated with higher cumulative incidence of further decompensation and death in Kaplan-Meier and Nelson-Aalen curves. Additionally, hs-cTnT>14 ng/L was significantly associated with increased risk of further decompensation and death in multivariate competing risk analyses (further decompensation: sHR=1.614, p = 0.012; death: sHR=2.041, p = 0.001), and hs-cTnT>14 ng/L was an independent predictor of death in multivariate Cox regression analyses (HR=1.677, p = 0.017). However, NT-ProBNP and unspecified CAD were not independently associated with further decompensation or death in multivariate competing risk and Cox regression analyses.

CONCLUSIONS

hs-cTnT and NT-ProBNP, rather than unspecified CAD, should be incorporated in the prognostic model of liver cirrhosis.