Journal Article

The Role of High-Sensitivity Troponin T Regarding Prognosis and Cardiovascular Outcome across Heart Failure Spectrum

Myftari, Vincenzo, Mariani, Marco Valerio, Di Pietro, Gianluca, Fedele, Francesco, D’Amato, Andrea, Cestiè, Claudia, Marek-Iannucci, Stefanie, Badagliacca, Roberto, Sardella, Gennaro, De Prisco, Andrea, Vizza, Carmine Dario, Severino, Paolo, Tabacco, Leonardo, Vari, Leonardo, Marano, Silvia Luisa, Lavalle, Carlo, Germanò, Rosanna, Prosperi, Silvia, Labbro Francia, Aurora, Mancone, Massimo

2024

Overview

Background: Cardiac troponin release is related to the cardiomyocyte loss occurring in heart failure (HF). The prognostic role of high-sensitivity cardiac troponin T (hs-cTnT) in several settings of HF is under investigation. The aim of the study is to assess the prognostic role of intrahospital hs-cTnT in patients admitted due to HF. Methods: In this observational, single center, prospective study, patients hospitalized due to HF have been enrolled. Admission, in-hospital peak, and discharge hs-cTnT have been assessed. Patients were followed up for 6 months. Cardiovascular (CV) death, HF hospitalization (HFH), and worsening HF (WHF) (i.e., urgent ambulatory visit/loop diuretics escalation) events have been assessed at 6-month follow up. Results: 253 consecutive patients have been enrolled in the study. The hs-cTnT median values at admission and discharge were 0.031 ng/mL (IQR 0.02–0.078) and 0.031 ng/mL (IQR 0.02–0.077), respectively. The risk of CV death/HFH was higher in patients with admission hs-cTnT values above the median (p = 0.02) and in patients who had an increase in hs-cTnT during hospitalization (p = 0.03). Multivariate Cox regression analysis confirmed that hs-cTnT above the median (OR: 2.06; 95% CI: 1.02–4.1; p = 0.04) and increase in hs-cTnT during hospitalization (OR:1.95; 95%CI: 1.006–3.769; p = 0.04) were predictors of CV death/HFH. In a subgroup analysis of patients with chronic HF, hs-cTnT above the median was associated with increased risk of CV death/HFH (p = 0.03), while in the subgroup of patients with HFmrEF/HFpEF, hs-cTnT above the median was associated with outpatient WHF events (p = 0.03). Conclusions: Inpatient hs-cTnT levels predict CV death/HFH in patients with HF. In particular, in the subgroup of chronic HF patients, hs-cTnT is predictive of CV death/HFH; while in patients with HFmrEF/HFpEF, hs-cTnT predicts WHF events.

• Publisher: MDPI AG,MDPI
• Subject: Biomarkers / Chronic illnesses / Development and progression / Diuretics / Ejection fraction / Heart failure / Hospitalization / Medical prognosis / Mortality / Multivariate analysis / Patient outcomes / Peptides / Prognosis / Statistical analysis / Survival analysis / Variables