Elevated baseline cardiac troponin T confers worse outcomes in VICTORIA population
Elevated baseline high-sensitivity cardiac troponin T was associated with CV death and HF hospitalization in patients from the VICTORIA trial, according to a presentation at the American College of Cardiology Scientific Session.
The researchers analyzed whether baseline cardiac troponin T was associated with the VICTORIA trial’s primary endpoint of CV death or HF hospitalization and its components. They also analyzed whether there were differences by troponin level in the treatment effect from vericiguat (Verquvo, Merck).
Among the 4,614 patients from VICTORIA for whom baseline cardiac troponin T levels were available, median cardiac troponin T was 30 ng/L (interquartile range, 19-49).
As baseline cardiac troponin T rose, there was greater risk for the primary outcome (HR per 1 standard deviation [SD] = 1.21; 95% CI, 1.14-1.27), CV death (HR per 1 SD = 1.22; 95% CI, 1.13-1.32) and HF hospitalization (HR per 1 SD = 1.21; 95% CI, 1.13-1.29), even accounting for the optimized VICTORIA risk model including N-terminal pro-B-type natriuretic peptide, according to the researchers.
“Measuring cardiac troponin T at baseline improved risk stratification even when including a comprehensive model of clinical covariates and NT-proBNP level. Baseline cardiac troponin T was significantly associated with cardiovascular death and heart failure hospitalization in VICTORIA,” Christopher R. deFilippi, MD, vice chairman of academic affairs at Inova Heart and Vascular Institute in Falls Church, Virginia, and colleagues wrote on a poster.
According to the researchers, the treatment effect of vericiguat was greater at lower baseline cardiac troponin levels.
When the VICTORIA risk model was used, there was a treatment-effect interaction between assignment to vericiguat and cardiac troponin T level for CV death (P for interaction = .04) but not HF hospitalization (P for interaction = .38).
Reference:
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deFilippi CR, et al. Omics, AI and Precision Medicine in Heart Failure. Presented at: American College of Cardiology Scientific Session; May 15-17, 2021 (virtual meeting).
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