Even Slightly Elevated hs-cTnT Levels Associated With Mortality Risk

Any detectable level of high-sensitivity cardiac troponin T (hs-cTnT) is associated with an increased risk of cardiovascular events and death among patients with chest pain, according to a recent study.

In their study, the researchers analyzed the hs-cTnT levels of 19,460 patients who presented with chest pain that was not related to myocardial infarction or acute conditions that would affect hs-cTnT levels at an emergency department in Stockholm, Sweden from 2011 to 2014 (mean age 54 years). They used Cox regression to estimate the risk for all-cause, cardiovascular, and non-cardiovascular mortality, myocardial infarction, and heart failure based on various levels of hs-cTnT.
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During the mean 3.3 years of follow-up, 1349 (6.9%) patients died.

Overall, the researchers identified a strong and graded association between all detectable levels of hs-cTnT and risk for myocardial infarction and heart failure, as well as cardiovascular and non-cardiovascular mortality.

Compared with patients whose hs-cTnT levels were below 5 ng/l, the hazard ratio for all-cause mortality was 2 for those with hs-cTnT levels of 5 to 9 ng/l, 2.29 for 10 to 14 ng/l, 4.07 for 15 to 29 ng/l, 6.77 for 30 to 49 ng/l, and 9.68 for 50 ng/l or more.

“Among patients with chest pain and stable troponin levels, any detectable level of hs-cTnT is associated with an increased risk of death and cardiovascular outcomes and should merit further attention,” the researchers concluded.

—Melissa Weiss

Reference:

Roos A, Bandstein N, Lundbäck M, Hammarsten O, Ljung R, Holzmann MJ. Stable high-sensitivity cardiac troponin T levels and outcomes in patients with chest pain [published online October 23, 2017]. J Am Coll Cardiol. doi:10.1016/j.jacc.2017.08.064.