High-sensitivity Troponin T is Detectable in Most Patients with Clinically Stable Heart Failure

Kristopher S Lyons; Gareth McKeeman; Gary E McVeigh; Mark T Harbinson

Disclosures

Br J Cardiol. 2014;21(1):33-36. 

In This Article

Results

In total, 32 patients were recruited. The majority were male (78%). Mean age was 63.5 years (standard deviation [SD] 10.9). Mean body mass index (BMI) was 30.4 (SD 6.0) and seven patients had a BMI >35 kg/m2. Six patients (20%) were diabetic and 12 (37.5%) had a history of atrial fibrillation. Four (12.5%) patients had significant valvular heart disease (classified as at least moderate valve regurgitation or stenosis). The mean serum creatinine was 103 mmol/L (SD 28.6). There were 14 patients (43.8%) taking antiplatelet therapy (all aspirin) and 14 (43.8%) were taking warfarin. Patients were on typical HF therapy to include beta blockers (90.6%), ACE inhibitors or ARBs (96.9%) and spironolactone (56.3%). Overall, 16 patients (50%) had non-ischaemic cardiomyopathy. All patients were in New York Heart Association (NHYA) class II (46.9%) or III (53.1%) and mean ejection fraction was 31% (SD 9.6). Eight patients (25%) had an implantable cardiac device.

HsTnT levels were available for 31 patients. The frequency histogram for baseline troponin levels in the patient group is shown in figure 1.

Figure 1.

Frequency histogram of baseline high-sensitivity troponin T (hsTnT) levels in patients

Median hsTnT was 13.9 ng/L (interquartile range [IQR] 9.2–21.6): 27 (84.4%) patients had detectable levels of hsTnT in plasma and 14 (43.8%) patients had levels above the 99th percentile of the normal range (commonly used as the cut-off for diagnosis of ACS).

As cardiac troponins are generally used in the diagnosis of ischaemic cardiac syndromes, comparison was made between hsTnT levels in patients with ischaemic and non-ischaemic cardiomyopathies at baseline. There were 12 (75%) patients in the non-ischaemic group and 15 (94%) in the ischaemic group with detectable levels of hsTnT at baseline, while seven (44%) patients in the non-ischaemic group and six (38%) in the ischaemic group had levels greater than 14 ng/L. These differences were not statistically significant (p=0.33 for any detectable level and p=1.0 for level >14 ng/L). Serum levels were similar in ischaemic (median 13.93 ng/L, IQR 11.8–20.2) and non-ischaemic (median 13.71 ng/L, IQR 4.6–26.3) groups (p=0.80).

In a subgroup of 16 patients, hsTnT levels were repeated after a period of four to six weeks. The median change in hsTnT was –1.2 ng/L (IQR –7.0 to +1.4) and this was not statistically significant (p=0.177).

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