Prognostic value of high sensitivity troponin T in patients with acutely decompensated heart failure and non-detectable conventional troponin T levels

Background.Patients presenting with acutely decompensated heart failure (ADHF) and positive circulating cardiac troponins were found to be a high-risk cohort. The advent of high-sensitive troponins resulted in a detection of positive troponins in a great proportion of heart failure patients. However, the pathophysiological significance of this phenomenon is not completely clear.Objectives.The aim of this study is to determine the early evolution and clinical significance of high-sensitivity troponin T (hsTnT) in ADHF.Methods.Retrospective, secondary analysis of a prospective study including 100 patients with ADHF.Results.Globally, high-sensitivity troponin T decreased from day 1 to day 3(P=0,039). However, in the subgroup of patients who remained decompensated no significant differences in hsTnT from day 1 to day 3 were observed(P=0,955), whereas in successfully compensated patients a significant reduction in hsTnT levels was observed(P=0,025). High-sensitivity troponin T decrease was correlated with NTproBNP reduction(P=0,007). Patients with hsTnT increase had longer length of stay(P=0,033).Conclusions.Episodes of ADHF are associated with transient increases in the blood levels of hsTnT that are reduced with effective acute episode treatment. The decrease in hsTnT can translate less myocardial damage along with favourable ADHF treatment.

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Comparison of soluble ST2, pentraxin-3, galectin-3, and high-sensitivity troponin T of cardiovascular outcomes in patients with acute decompensated heart failure

Journal of Cardiac Failure ◽

10.1016/j.cardfail.2021.05.025 ◽

2021 ◽

Author(s):

Masayoshi Yamamoto ◽

Yoshihiro Seo ◽

Tomoko Ishizua ◽

Daishi Nakagawa ◽

Kimi Sato ◽

...

Keyword(s):

Heart Failure ◽

Troponin T ◽

Acute Decompensated Heart Failure ◽

High Sensitivity ◽

Decompensated Heart Failure ◽

Cardiovascular Outcomes ◽

Pentraxin 3 ◽

Soluble St2 ◽

Galectin 3 ◽

High Sensitivity Troponin T

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Abstract 12777: High Sensitivity Troponin T is Associated With Increased Heart Failure Risk in Metabolic Syndrome in the Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽

10.1161/circ.130.suppl_2.12777 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Yashashwi Pokharel ◽

Wensheng Sun ◽

Dennis Villarael ◽

Elizabeth Selvin ◽

Salim Virani ◽

...

Keyword(s):

Heart Failure ◽

Metabolic Syndrome ◽

Myocardial Injury ◽

Troponin T ◽

Cox Model ◽

High Sensitivity ◽

Cvd Risk ◽

Chi Square ◽

High Sensitivity Troponin ◽

High Sensitivity Troponin T

Background: Metabolic syndrome (MS) is associated with higher CVD risk. High sensitivity troponin T (hsTnT) is a marker of myocardial injury and an emerging marker for heart failure (HF) risk prediction. We examined whether hsTnT is associated with increased HF risk in people with similar number of MS components present at baseline in 10316 ARIC participants without prevalent HF. Methods: We used Wald Chi-square test to assess the interaction between MS and hsTnT and Cox model for the association of incident HF hospitalization by hsTnT categories across groups created by the number of MS components after adjusting for risk factors and NT-proBNP (Table). Results: The mean age of the study population was 63 (SD, 6) years (56% women). Mean hsTnT levels were higher with increasing MS components (Table). There were 1353 HF hospitalizations over a median of 14 years. The interaction of MS with hsTnT for HF was borderline significant (p-interaction 0.059). Compared to individuals without MS and hsTnT<5 ng/L the HRs (95%CIs) were 1.7 (1.4-2.1) in those without MS and hsTnT≥5 ng/L; 1.7 (1.3-2.1) in MS and hsTnT<5 ng/L; and 3.6 (3.0-4.4) in MS and hsTnT≥5 ng/L. In groups with 1-5 MS components present, increasing hsTnT was significantly associated with higher hazards for HF in each group with the highest HR in those with all 5 MS components (Table). Conclusion: Presence of higher MS risk components was associated with increasing subclinical myocardial injury as assessed by higher hsTnT. The hazards for HF were numerically similar in individuals without MS but detectable hsTnT (>5 ng/L) as to those with MS but undetectable hsTnT. In people with similar number of MS components higher hsTnT levels were associated with increased HF hazards suggesting that in MS hsTnT could be a useful marker for identifying those at higher risk for incident HF.

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