High sensitivity troponin T tied to increased risk for incident heart failure

  • Welsh P & al.
  • J Card Fail
  • 10 Aug 2018

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • Elevated high sensitivity troponin T (hsTnT) level is consistently associated with risk for heart failure (HF) in older men, and HF rarely occurs when baseline hsTnT level is near the detection limit.
  • Although useful in HF prediction when added to traditional risk factors, TnT does not improve HF prediction when added to N-terminal pro-B-type natriuretic peptide (NT-proBNP).

Why this matters

  • Circulating cardiac troponin levels are excellent biomarkers for myocardial injury, including ischaemia.
  • Findings suggest that subclinical myocardial damage may be an important risk factor for HF even in individuals without diagnosed coronary heart disease.

Study design

  • The British Regional Heart Study of 3852 men (aged 60-79 years) without baseline HF was followed up for a median of 12.6 years.
  • Funding: The British Heart Foundation Programme grant.

Results

  • During median follow-up, 295 (7.7%) incident cases of HF were reported.
  • After adjustment for classical risk factors (HR, 1.58; P<.001 and nt-probnp p per sd increase in log-transformed hstnt was associated with higher risk for incident hf.>
  • Patients with baseline hsTnT levels (
  • HF risk score based on classical risk factors and NT-proBNP yielded a c-index of 0.791, but the addition of hsTnT did not improve HF prediction (P=.28).

Limitations

  • Likelihood of misclassification of outcomes including under-reporting of incident HF.

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