Troponin-T Monitoring in Outpatients With Nonischemic Heart Failure

• Published in: Revista española de cardiología (English ed.) 2008, Vol.61 (7), p.678-686
• Main Authors: Pascual-Figal, Domingo A., Manzano-Fernández, Sergio, Pastor, Francisco, Garrido, Iris P., Casas, Teresa, Más, Jesús Sánchez, Ansaldo, Pilar, Martínez, Pedro, Valdés, Mariano
• Format: Article
• Language: English
• Subjects: Heart failure; Insuficiencia cardiaca; NT-proBNP; Prognosis; Pronóstico; Troponin T; Troponina T
• ISSN: 1885-5857; 1885-5857
• DOI: 10.1016/S1885-5857(08)60204-2

The usefulness of prolonged troponin-T (TnT) monitoring in outpatients with nonischemic heart failure (HF) is not clear. The aim of this study was to investigate the incidence, prognostic value, and determinants of a raised TnT level. The study involved 80 outpatients (age 56[14] years, 69% male) with chronic stable HF (mean left ventricular ejection fraction, 24[9]; 51 in New York Heart Association class II and 29 in class III) of non-ischemic origin, as confirmed with coronary angiography. The TnT level was measured at study entry and at every outpatient visit (median interval, 3.1 months; interquartile range [IQR], 1.8-5.0 months) in a follow-up period of 22.2(10.6) months. Patients were TnT+ if the level was measurable (ie, >0.01 ng/mL). At study entry, 7 (9%) patients were TnT+. By 5 years, the cumulative incidence had reached 53%, and the median TnT level was 0.059 ng/mL (IQR, 0.023-0.100 ng/mL; range, 0.013-0.500 ng/mL). Beta-blocker therapy was associated with a reduction in incidence (hazard ratio [HR]=0.220; 95% confidence interval [CI], 0.089-0.540; P =.001) while the incidence increased with the N-terminal probrain natriuretic peptide (NT-proBNP) level (HR=1.005; 95% CI, 1.001-1.010; P =0.021). During follow-up, 14 (17.5%) patients had a cardiac event (ie, 9 cardiac deaths and 5 urgent transplants); these occurred in 12 (50%) of the 24 TnT+ patients versus 2 (3.6%) of the 56 TnT– patients ( P