Cardiac Troponin T Measured by a Highly Sensitive Assay Predicts Coronary Heart Disease, Heart Failure, and Mortality in the Atherosclerosis Risk in Communities Study

Abstract

Background We evaluated whether cardiac troponin T (cTnT) measured with a new highly sensitive assay was associated with incident coronary heart disease (CHD), mortality, and hospitalization for heart failure (HF) in a general population of participants in the Atherosclerosis Risk in Communities (ARIC) Study. Methods and Results Associations between increasing cTnT levels and CHD, mortality, and HF hospitalization were evaluated using Cox proportional-hazards models adjusted for traditional CHD risk factors, kidney function, high-sensitivity C-reactive protein (hs-CRP), and N-terminal pro–B-type natriuretic peptide (NT-proBNP) in 9,698 participants aged 54–74 years who at baseline were free from CHD and stroke (and HF in the HF analysis). Measurable cTnT levels (≥0.003 μg/L) were detected in 66.5% of individuals. In fully adjusted models, compared with participants with undetectable levels, those with cTnT levels in the highest category (≥0.014 μg/L, 7.4% of the ARIC population) had significantly increased risk for CHD (hazard ratio [HR] 2.29, 95% confidence interval [CI] 1.81–2.89), fatal CHD (HR 7.59, 95% CI 3.78–15.25), total mortality (HR 3.96, 95% CI 3.21–4.88), and HF (HR 5.95, 95% CI 4.47–7.92). Even minimally elevated cTnT (≥0.003 μg/L) was associated with increased risk for mortality and HF (p<0.05). Adding cTnT to traditional risk factors improved risk prediction parameters; the improvements were similar to those with NT-proBNP and better than that with the addition of hs-CRP. Conclusions cTnT detectable with a highly sensitive assay was associated with incident CHD, mortality, and HF in individuals from a general population without known CHD/stroke.

High-sensitivity troponin-T as a prognostic marker after out-of-hospital cardiac arrest – A targeted temperature management (TTM) trial substudy

“…The correlation between hs-TnT and death due to cardiovascular causes or multi-organ failure corresponds with previous findings in patients with and without acute coronary syndromes [18,19]. Furthermore, Troponin within the first days after STEMI without OHCA is associated with infarct size, left ventricular function as well as mortality in several studies [20][21][22].…”

Randomized Trial of the Effects of Insulin and Metformin on Myocardial Injury and Stress in Diabetes Mellitus: A Post Hoc Exploratory Analysis

“…Higher proportions have been reported in other cohorts (eg, 39% in the BARI 2D [Bypass Angioplasty Revascularization Investigation 2 Diabetes] trial) 10. In patients with diabetes mellitus with and without established cardiovascular disease, cardiac troponin concentrations are a significant predictor of myocardial infarction, stroke, heart failure, and cardiovascular death 9, 10, 23, 24. As a result, there is considerable interest in identifying treatment strategies that might modify troponin concentrations and thus confer cardiovascular benefit.…”

High-Sensitivity Troponin T and N-Terminal Pro-B-Type Natriuretic Peptide (NT-proBNP) and Risk of Incident Heart Failure in Patients with CKD

“…5,6 NTproBNP is secreted from cardiac myocytes in response to myocardial stretch from pressure or volume overload, 7 and levels increase with increasing left ventricular mass. [8][9][10] Through complementary physiologic pathways, concentrations of hsTnT may become elevated in response to myocardial injury or remodeling or left ventricular hypertrophy (LVH).…”