High-sensitivity cardiac troponin T predicts non-cardiac mortality in heart failure.
BACKGROUND
Cardiac troponins are independent predictors of cardiac mortality in patients with heart failure (HF). Recently, elevation of troponins was described in non-cardiac diseases such as stroke and infection, among others, but it remains unclear whether high-sensitivity troponin T (hs-TnT) predicts non-cardiac mortality in HF patients.


RESULTS
Four-hundred and forty-four consecutive HF patients admitted to hospital for the treatment of decompensated HF were divided into 2 groups based on median hs-TnT: group L (<0.028ng/ml, n=220) and group H (≥0.028ng/ml, n=224). We compared all-cause mortality and echocardiographic findings between the 2 groups. In the follow-up period (mean 472 days), 77 deaths (49 cardiac deaths and 28 non-cardiac deaths) were observed. The event-free rate was significantly lower in group H than in group L for non-cardiac death (P=0.025), cardiac death (P<0.001), and all-cause mortality (P<0.001). On multivariate Cox proportional hazard analysis, high hs-TnT was found to be an independent predictor of non-cardiac death (P=0.042), cardiac death (P<0.001) and all-cause mortality (P<0.001) in HF patients after adjusting for risk factors. Regarding echocardiographic parameters, left ventricular wall thickness was higher (P<0.001), and ejection fraction was lower (P=0.011) in group H than in group L.


CONCLUSIONS
Hs-TnT is an independent predictor not only of cardiac mortality, but also of non-cardiac mortality in HF patients.
Department of Cardiology and Hematology, Fukushima Medical University.
Yuichi
Y
Nakamura
Akiomi
A
Yoshihisa
Mai
M
Takiguchi
Takeshi
T
Shimizu
Hiroyuki
H
Yamauchi
Shoji
S
Iwaya
Takashi
T
Owada
Makiko
M
Miyata
Satoshi
S
Abe
Takamasa
T
Sato
Satoshi
S
Suzuki
Masayoshi
M
Oikawa
Atsushi
A
Kobayashi
Takayoshi
T
Yamaki
Koichi
K
Sugimoto
Hiroyuki
H
Kunii
Kazuhiko
K
Nakazato
Hitoshi
H
Suzuki
Shu-Ichi
S
Saitoh
Yasuchika
Y
Takeishi
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D020107:Troponin T / Q000097:blood*
D020107:Troponin T