High-Sensitivity Cardiac Troponin as a Predictor for Incident Heart Failure

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Men and women had similar hazard ratios for incident heart failure based on hs-cTn levels.
Men and women had similar hazard ratios for incident heart failure based on hs-cTn levels.

The presence of high-sensitivity cardiac troponin (hs-cTn) is associated with incident heart failure (HF) and may act as a clinical risk stratification tool for high-risk patients, according to findings from a systematic review published in JACC: Heart Failure.

For this review, investigators searched clinical trials databases (Embase, PubMed, and Web of Science) to identify 16 prospective cohort studies reporting hs-cTn levels and incident HF in participants who did not have HF at baseline (n=67,063). A total of 4165 incidence HF events occurred in these individuals.

Patients in the top third were compared with those in the bottom third of baseline hs-cTn values. The hazard ratio for incident HF of this pooled cohort was 2.09 (95% CI, 1.76-2.48; P <.001). 

In addition, there were no significant differences in hazard ratios between men and women (2.29 [95% CI, 1.64-3.21] vs 2.18 [95% CI, 1.68-2.81], respectively), nor were any differences found between hs-cTnI and hs-cTnT assays (2.09 [95% CI, 1.53-2.85] vs 2.11 [95% CI, 1.69-2.63]).

With the included studies, this analysis possessed a high level of heterogeneity that could have affected the findings. The investigators also noted that incomplete reporting of CI values for the C index could have prevented quantitative data synthesis.

The data presented in this study demonstrated that, “discrimination improvements in HF risk with hs-cTn assessment suggest that it [hs-cTn] may be a promising biomarker for measurement as part of primary prevention of HF.”

Reference

Evans JDW, Dobbin SJH, Pettit SJ, Di Angelantonio E, Willeit P. High-sensitivity cardiac troponin and new-onset heart failure: a systematic review and meta-analysis of 67,063 patients with 4,165 incident heart failure events [published online January 3, 2018]. JACC Heart Fail. doi:10.1016/j.jchf.2017.11.003

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