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Published on: October 10, 2019

Prognostic value of cardiac troponin in chronic stable heart failure: a systematic review

Vijaiganesh Nagarajan1, Adrian V Hernandez, W H Wilson Tang

  • 1Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH 44195, USA.

Heart (British Cardiac Society)
|November 3, 2012
PubMed

Insights

Elevated cardiac troponins in chronic stable heart failure indicate higher mortality risk. Both high-sensitivity and low-sensitivity troponin assays show similar prognostic value for these patients.

Area of Science:

  • Cardiology
  • Biomarkers
  • Prognostics

Background:

  • Cardiac troponins are key for diagnosing myocardial infarction.
  • Elevated troponin levels are observed in chronic stable heart failure (CSHF).
  • The prognostic significance of different troponin assay types in CSHF is not well-established.

Purpose of the Study:

  • To systematically review the prognostic value of various cardiac troponin assays (low and high sensitivity) in patients with CSHF.

Main Methods:

  • A systematic search of PubMed, The Cochrane Library, and Web of Science was conducted in April 2012.
  • Included studies focused on prognosis based on baseline cardiac troponin levels in adult CSHF patients.
  • Data extraction and review were performed by two independent authors.

Main Results:

  • 16 studies were included, analyzing 365 papers.
  • Elevated baseline cardiac troponin in CSHF patients correlated with increased mortality (HR 2.85) and adverse cardiovascular outcomes (HR 2.38).
  • High-sensitivity assays detected troponin in more patients than low-sensitivity assays, but this difference was not statistically significant (p=0.54).

Conclusions:

  • Baseline elevated cardiac troponin levels identify CSHF patients at higher risk for mortality and adverse cardiovascular events.
  • No significant prognostic difference was found between high-sensitivity and low-sensitivity cardiac troponin assays in CSHF.
Abstract

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