Temporal Changes of Stable High-Sensitivity Cardiac Troponin T Levels and Prognosis
Andreas Roos1,2, Gustaf Edgren3,4, Martin J Holzmann1,2
1Department of Medicine Karolinska Institutet, Solna Stockholm Sweden.
Journal of the American Heart Association
|May 27, 2022
Summary
Temporal changes in high-sensitivity cardiac troponin T (hs-cTnT) indicate prognosis. An increase in hs-cTnT, especially with myocardial injury, significantly elevates risks for mortality and cardiovascular events.
Area of Science:
- Cardiology
- Biomarkers
- Prognostic Medicine
Background:
- Prognostic implications of temporal changes in stable high-sensitivity cardiac troponin T (hs-cTnT) concentrations were previously unknown.
- High-sensitivity cardiac troponin T is a key biomarker for diagnosing myocardial injury.
Purpose of the Study:
- To investigate the prognosis associated with temporal changes in stable hs-cTnT concentrations.
- To assess the association between hs-cTnT changes and all-cause mortality and cardiovascular events.
Main Methods:
- Retrospective analysis of 12,869 patients with cardiac symptoms and at least two hs-cTnT measurements from 7 Swedish emergency departments.
- Hazard ratios (HRs) were calculated for mortality and cardiovascular events based on hs-cTnT changes over time, with a focus on patients with and without myocardial injury.
Main Results:
- Among 12,869 patients, 5191 (40%) had myocardial injury (hs-cTnT ≥15 ng/L).
- In patients with myocardial injury and increasing hs-cTnT, adjusted all-cause mortality risk was 4.21-fold elevated and cardiovascular mortality risk was 5.08-fold elevated.
- An increasing hs-cTnT in patients with myocardial injury showed a 2.77-fold increased risk of heart failure hospitalization.
Conclusions:
- Temporal changes in previously stable hs-cTnT concentrations are significantly associated with prognosis.
- Increasing hs-cTnT in patients with myocardial injury indicates a substantially elevated risk of death and adverse cardiovascular outcomes.
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