Prediction of coronary heart disease or heart failure using high-sensitivity cardiac troponin T: A pilot study

Area of Science:

• Cardiology
• Biomarkers
• Preventive Medicine

Background:

• High-sensitivity cardiac troponin T (hs-cTnT) is a recognized prognostic marker for mortality.
• The utility of hs-cTnT in detecting sub-clinical cardiac disease remains unclear.

Purpose of the Study:

• To investigate the association between elevated hs-cTnT levels and sub-clinical cardiac disease in patients without known heart conditions.
• To evaluate the diagnostic performance of hs-cTnT for identifying early-stage cardiovascular abnormalities.

Main Methods:

• A pilot study involving patients presenting to the emergency department with elevated hs-cTnT and no prior heart disease diagnosis.
• Hs-cTnT levels were measured using Roche Diagnostics assays.
• Cardiac structure and coronary artery disease were assessed via echocardiography and computed tomography angiography, respectively, including Agatston scoring.

Main Results:

• Ten patients were analyzed, with a median age of 68 years and 80% female.
• Median hs-cTnT level was 26 ng/L (range: 19-495 ng/L); median Agatston score was 12.
• Three patients (30%) exhibited signs of coronary artery disease; two had increased left ventricular mass index, while all maintained normal ejection fraction.

Conclusions:

• Elevated hs-cTnT in the absence of acute illness may not always correlate with significant structural or ischemic heart disease.
• A notable proportion of individuals with elevated hs-cTnT showed evidence of coronary artery disease, potentially benefiting from preventive therapies.
• Measuring hs-cTnT outside of acute cardiac events could serve as a valuable tool for identifying sub-clinical cardiovascular disease.