Prognostic value of high sensitivity troponin T in patients with acutely decompensated heart failure and non-detectable conventional troponin T levels.

Background: High-sensitivity troponin Τ (hs-TnΤ) allows the detection of very minor myocardial injury and has emerged as a novel prognostic marker in patients with cardiovascular disease. The aim of the present study was to determine the prognostic utility of hs-TnΤ levels in patients admitted to hospital for acutely decompensated heart failure (ADHF) and non-detectable conventional TnΤ levels.

Methods: We prospectively enrolled 113 consecutive ADHF patients [77 (68%) men], mean age: 72.7±11.3 years, presented at admission with normal (<0.03 ng/ml) conventional (4th generation) TnΤ levels. Hs-TnΤ levels were measured by relevant commercially available kits and patients were monitored for major adverse events during a median follow-up period of 174 days (94-728 days).

Results: In the univariate Cox proportional hazard analysis, hs-TnΤ was significantly related to death (HR=1.002 with 95%: confidence interval (CI) 1.001-1.003, P=0.001). In multivariate analysis, it remained a significant predictor of death after adjustment for age, gender, ejection fraction and creatinine levels (HR=1.003 with 95%: CI 1.001-1.005, P=0.008).

Conclusion: hs-TnΤ seems to identify high risk patients hospitalized for ADHF, independently of other classical prognostic biomarkers. Further studies are necessary to confirm the utility of this novel biomarker in risk stratification and management of patients with ADHF.