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High-sensitivity cardiac troponin T levels predicted secondary CV events

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New data suggest that there is a potential link between elevated high-sensitivity cardiac troponin T levels and an increased risk for secondary CV events and multiple cardiac abnormalities in patients with stable CHD.

In a prospective cohort study of 984 outpatients from the Heart and Soul Study with stable CHD, researchers measured high-sensitivity cardiac troponin T and performed exercise treadmill testing using stress echocardiography. Patients were enrolled from September 2000 to December 2002 at 12 outpatient clinics in the San Francisco Bay area.

Researchers found that 80.7% had detectable levels of high-sensitivity cardiac troponin T (>5 pg/mL). Increased levels of high-sensitivity cardiac troponin T were associated with inducible ischemia, worse left ventricular ejection fraction, left atrial function, diastolic function, left ventricular mass and treadmill exercise capacity at baseline.

After a mean follow-up of 8.2 years, 32.2% of study participants experienced a CV event. Each doubling of high-sensitivity cardiac troponin T levels was associated with a higher rate of CV events after adjustment for clinical risk factors, baseline cardiac structure and function and other biomarkers (N-terminal portion of the prohormone of brain-type natriuretic peptide and C-reactive protein levels; HR=1.37; 95% CI, 1.14-1.65), according to research published in JAMA Internal Medicine.

“We found that levels of high-sensitivity cardiac troponin T were associated with measures of cardiac structure and function with CV events independent of clinical risk factors, echocardiographic measures of heart disease, exercise capacity and biomarkers,” Alexis L. Beatty, MD, of the department of medicine and epidemiology and biostatistics at the University of California, San Francisco, wrote. “These findings support the potential use of high-sensitivity cardiac troponin T as a marker of risk in stable outpatients with CHD.”

For more information:

Beatty AL. JAMA Intern Med. 2013;doi:10.1001/jamainternmed.2013.116.

Disclosure: One of the researchers reports receiving grants from Roche Diagnostics.