Three-year changes in high-sensitivity cardiac troponin-T and total mortality in older adults

Area of Science:

• Gerontology
• Cardiology
• Biomarkers

Background:

• Elevated high-sensitivity cardiac troponin-T (hs-cTnT) is a known mortality predictor in older adults.
• The prognostic value of hs-cTnT changes over time remains less understood.

Purpose of the Study:

• To investigate the association between 3-year changes in hs-cTnT levels and subsequent mortality in older adults.
• To identify specific hs-cTnT trajectories indicative of heightened mortality risk.

Main Methods:

• The Activity and Function in the Elderly Study cohort was used, with participants categorized into groups based on baseline and 3-year follow-up hs-cTnT levels.
• Cox-proportional hazards models were employed to assess mortality risk, adjusting for multiple covariates including age, sex, comorbidities, and other biomarkers (hs-CRP, NT-proBNP).

Main Results:

• A total of 745 participants were analyzed, with 98 deaths observed over a median follow-up of 4.8 years.
• The lowest mortality rate was in the reference group with stable hs-cTnT <5 ng/L.
• Significantly higher mortality rates were observed in groups with follow-up hs-cTnT ≥14 ng/L (adjusted Hazard Ratios of 5.22 and 3.40 for specific trajectories).

Conclusions:

• Hs-cTnT trajectories, particularly sustained or emergent levels ≥14 ng/L, are significant independent predictors of mortality in older adults.
• Monitoring hs-cTnT changes over time offers valuable prognostic information for identifying high-risk individuals, even when accounting for other clinical factors and biomarkers.