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Troponin and BNP are markers for subsequent non-ischaemic congestive heart failure: the Caerphilly Prospective Study

Christopher C Patterson1, Stefan Blankenberg2,3, Yoav Ben-Shlomo4

  • 1Centre for Public Health, Queen's University Belfast, Belfast, UK.

Open Heart
|March 14, 2018
PubMed

Insights

Troponin and B-type natriuretic peptide (BNP) show significant long-term predictive value for congestive heart failure (CHF) risk in men without prior cardiovascular disease. These biomarkers may aid in early identification of individuals at high risk for developing CHF.

Area of Science:

  • Biomarkers
  • Cardiovascular Disease
  • Epidemiology

Background:

  • The Caerphilly Prospective Study cohort of 2171 men aged 55-69 years was established to investigate cardiovascular disease (CVD) risk factors.
  • Longitudinal data collection and stored biosamples allow for retrospective analysis of novel biomarkers for predicting future cardiovascular events.

Purpose of the Study:

  • To assess the long-term predictive capacity of 28 biomarkers for non-ischaemic congestive heart failure (CHF).
  • To evaluate the predictive value of these biomarkers for other cardiovascular outcomes, specifically myocardial infarction (MI) and stroke.

Main Methods:

  • Utilized competing risks proportional hazards regression analysis to estimate subhazard ratios (SHRs) for each biomarker.
  • Assayed stored blood samples from 1989-1993 for novel biomarkers in 2010-2013, with an average follow-up of 13 years.
  • Focused on initial cardiovascular events, including 584 MIs, 313 strokes, and 261 CHF episodes not associated with acute MI.

Main Results:

  • In a subcohort (n=1279) free of baseline CVD, elevated troponin and B-type natriuretic peptide (BNP) in the top third of distributions predicted subsequent CHF.
  • Men with high troponin or BNP levels had a threefold increased risk of incident CHF (SHRs 3.37 and 3.23, respectively) after adjusting for conventional risk factors.
  • Troponin showed a moderate association with MI risk (SHR 1.63), and BNP with stroke risk (SHR 1.75).

Conclusions:

  • Troponin and BNP show potential as screening tools for identifying individuals at elevated risk of developing CHF, particularly those without a history of CVD.
  • These biomarkers have a lesser, though still notable, role in predicting subsequent MI (troponin) and stroke (BNP).
Abstract

Keywords:
atherosclerosisepidemiologyheart failurestroke

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