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