Changes to Long-Term Cardiac Troponin Linked to Increased Heart Failure Risk
Long-term increases in high-sensitivity cardiac troponin T (hs-cTnT) are associated with increased risk of coronary heart disease (CHD), heart failure (HF), and death, and analysis of trajectory hs-cTnT could add beneficial information to baseline testing of high-risk individuals, according to the results of a recent study.
While previous research has suggested that hs-cTnT is an effective biomarker for cardiovascular risk, data on changes to hs-cTnT over time, and how these changes effect outcomes, are limited.
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To further examine this association, the researchers conducted a prospective observational cohort study including 8838 participants from the Atherosclerosis Risk in Communities Study who were free of CHD and HF. The participants had their hs-cTnT measured twice, 6 years apart.
Overall, there were 1157 reported CHD events, 965 HF events, and 1813 deaths. Incident detectable hs-cTnT (baseline, <0.005 ng/mL; follow-up, ≥0.005 ng/mL) was independently associated with CHD (hazard ratio [HR], 1.4; 95% confidence interval [CI], 1.2-1.6), HF (HR, 2.0; 95% CI, 1.6-2.4), and death (HR, 1.5; 95% CI, 1.3-1.7) relative to an hs-cTnT of less than 0.005 ng/mL at both visits.
Additionally, HRs of as high as 4 for CHD and 8 for HF were noted in individuals with the highest increases in hs-cTnT.
“Our results indicate that 2 measurements of hs-cTnT appear to be better than 1 for characterizing risk and that large increases in hs-cTnT are particularly deleterious,” the researchers concluded. “Temporal change in hs-cTnT may help guide the preventive management of asymptomatic persons at risk for CHD and adults with stage A or B HF (both the HFrEF and HFpEF subtypes).”
—Michael Potts
Reference:
McEvoy JW, Chen Y, Ndumele CE, et al. Six-year change in high-sensitivity cardiac troponin T and risk of subsequent coronary heart disease, heart failure, and death [published online June 8, 2016]. JAMA Cardiol. doi:10.1001/jamacardio.2016.0765.