Prognostic Value of Very Low Plasma Concentrations of Troponin T in Patients With Stable Chronic Heart Failure

• DOI: 10.1161/circulationaha.106.655076
• Publication Date: 2007-08-14T00:54:02Z
• Authors: Roberto Latini; Serge Masson; Inder S. Anand; Emil Missov; Marjorie Carlson; Tarcisio Vago; Laura Angelici; Simona Barlera; Giovanni Parrinello; Aldo P. Maggioni; Gianni Tognoni; Jay N. Cohn
• Keywords: Heart Failure; Male; Middle Aged; Prognosis; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Double-Blind Method; Troponin T; Chronic Disease; Humans; Female; Aged; Follow-Up Studies

Circulating cardiac troponin T, a marker of cardiomyocyte injury, predicts adverse outcome in patients with heart failure (HF) but is detectable only small fraction those chronic stable HF. We assessed the prognostic value circulating T HF traditional (cTnT) and new precommercial highly sensitive assay (hsTnT).Plasma was measured 4053 enrolled Valsartan Heart Failure Trial (Val-HeFT). Troponin 10.4% population cTnT (detection limit < or = 0.01 ng/mL) compared 92.0% hsTnT (< 0.001 ng/mL). Patients elevation above median (0.012 had more severe worse outcome. In Cox proportional hazards models adjusting for clinical risk factors, associated death (780 events; hazard ratio=2.08; 95% confidence interval, 1.72 to 2.52; P<0.0001) first hospitalization (655 ratio=1.55; 1.25 1.93; P<0.0001). HsTnT unadjusted analysis deciles concentrations multivariable (hazard ratio=1.05; 1.04 1.07 increments ng/mL; Addition well-calibrated adjusted without brain natriuretic peptide, significantly improved discrimination (C-index, P<0.0001 both outcomes).In this large HF, outcomes By assay, retains at previously undetectable concentrations.