title: Significance of high-sensitivity cardiac troponin T in hypertrophic cardiomyopathy.
abstract: OBJECTIVE
  This study investigated the significance of the serum high-sensitivity cardiac troponin T (hs-cTnT) marker for prediction of adverse events in hypertrophic cardiomyopathy (HCM).
  
  
  BACKGROUND
  Although serum cardiac troponins as sensitive and specific markers of myocardial injury have become well-established diagnostic and prognostic markers in acute coronary syndrome, the usefulness of hs-cTnT for prediction of cardiovascular events in patients with HCM is unclear.
  
  
  METHODS
  We performed clinical evaluation, including measurements of hs-cTnT in 183 consecutive patients with HCM.
  
  
  RESULTS
  Of 183 HCM patients, 99 (54%) showed abnormal hs-cTnT values (>0.014 ng/ml). During a mean follow-up of 4.1 ± 2.0 years, 32 (32%) of the 99 patients in the abnormal hs-cTnT group, but only 6 (7%) of 84 patients with normal hs-cTnT values, experienced cardiovascular events: cardiovascular deaths, unplanned heart failure admissions, sustained ventricular tachycardia, embolic events, and progression to New York Heart Association functional class III or IV status (hazard ratio [HR]: 5.05, p < 0.001). Abnormal hs-cTnT value remained an independent predictor of these cardiovascular events after multivariate analysis (HR: 3.23, p = 0.012). Furthermore, in the abnormal hs-cTnT group, overall risk increased with an increase in hs-cTnT value (HR: 1.89/hs-cTnT 1 SD increase in the logarithmic scale, 95% confidence interval: 1.13 to 3.15; p = 0.015 [SD: 0.59]).
  
  
  CONCLUSIONS
  In patients with HCM, an abnormal serum concentration of hs-cTnT is an independent predictor of adverse outcome, and a higher degree of abnormality in hs-cTnT value is associated with a greater risk of cardiovascular events.
authors.affiliation: Department of Medicine and Geriatrics, Kochi Medical School, Kochi, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Kubo
authors.affiliation: Department of Medicine and Geriatrics, Kochi Medical School, Kochi, Japan. Electronic address: kitaokah@kochi-u.ac.jp.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kitaoka
authors.affiliation: Department of Laboratory Medicine, Kochi Medical School, Kochi, Japan.
authors.forename: Shigeo
authors.initials: S
authors.lastname: Yamanaka
authors.affiliation: Department of Medicine and Geriatrics, Kochi Medical School, Kochi, Japan.
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Hirota
authors.affiliation: Department of Medicine and Geriatrics, Kochi Medical School, Kochi, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Baba
authors.affiliation: Department of Medicine and Geriatrics, Kochi Medical School, Kochi, Japan.
authors.forename: Kayo
authors.initials: K
authors.lastname: Hayashi
authors.affiliation: Clinical Trial Center, Kochi Medical School, Kochi, Japan.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Iiyama
authors.affiliation: Clinical Trial Center, Kochi Medical School, Kochi, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Kumagai
authors.affiliation: Department of Medicine and Geriatrics, Kochi Medical School, Kochi, Japan.
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Tanioka
authors.affiliation: Department of Medicine and Geriatrics, Kochi Medical School, Kochi, Japan.
authors.forename: Naohito
authors.initials: N
authors.lastname: Yamasaki
authors.affiliation: Department of Medicine and Geriatrics, Kochi Medical School, Kochi, Japan.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Matsumura
authors.affiliation: Department of Medicine and Geriatrics, Kochi Medical School, Kochi, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Furuno
authors.affiliation: Department of Laboratory Medicine, Kochi Medical School, Kochi, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Sugiura
authors.affiliation: Department of Medicine and Geriatrics, Kochi Medical School, Kochi, Japan.
authors.forename: Yoshinori L
authors.initials: YL
authors.lastname: Doi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002312:Cardiomyopathy, Hypertrophic / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D015996:Survival Rate / Q000639:trends; D020107:Troponin T / Q000097:blood*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D020107:Troponin T
keywords: 2-D; CI; FS; HCM; HR; ICD; IDI; LV; LVEDD; LVESD; MRI; NYHA; New York Heart Association; VT; biomarker; confidence interval; fractional shortening; hazards ratio; high-sensitivity cardiac troponin T; hs-cTnT; hypertrophic cardiomyopathy; implantable cardioverter-defibrillator; integrated discrimination improvement; left ventricular; left ventricular end-diastolic diameter; left ventricular end-systolic diameter; magnetic resonance imaging; prognosis; two-dimensional; ventricular tachycardia