Significance of High-Sensitivity Cardiac Troponin T in Hypertrophic Cardiomyopathy

• Published in: Journal of the American College of Cardiology 2013-10, Vol.62 (14), p.1252-1259
• Main Authors: Kubo, Toru, MD, Kitaoka, Hiroaki, MD, Yamanaka, Shigeo, MB, Hirota, Takayoshi, MD, Baba, Yuichi, MD, Hayashi, Kayo, MD, Iiyama, Tatsuo, MD, Kumagai, Naoko, MS, Tanioka, Katsutoshi, MD, Yamasaki, Naohito, MD, Matsumura, Yoshihisa, MD, Furuno, Takashi, MD, Sugiura, Tetsuro, MD, Doi, Yoshinori L., MD
• Format: Article
• Language: English
• Subjects: Abbreviations; Acute coronary syndromes; Adolescent; Adult; Aged; Aged, 80 and over; Biological and medical sciences; biomarker; Biomarkers - blood; Cardiac arrhythmia; Cardiology; Cardiology. Vascular system; Cardiomyopathy; Cardiomyopathy, Hypertrophic - blood; Cardiomyopathy, Hypertrophic - diagnosis; Cardiomyopathy, Hypertrophic - mortality; Cardiovascular; Cardiovascular disease; Confidence intervals; Echocardiography; Family medical history; Female; Follow-Up Studies; Heart; Heart attacks; Heart failure; high-sensitivity cardiac troponin T; Humans; hypertrophic cardiomyopathy; Internal Medicine; Japan - epidemiology; Kaplan-Meier Estimate; Male; Medical sciences; Middle Aged; Multivariate analysis; Myocarditis. Cardiomyopathies; Prognosis; Retrospective Studies; Sensitivity and Specificity; Statistical analysis; Stroke; Survival analysis; Survival Rate - trends; Troponin T - blood; Variables; Young Adult
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2013.03.055

Objectives 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.