Prognostic value of cardiac troponin T elevation is independent of renal function and clinical findings in heart failure patients

Abstract

BACKGROUND: The aim of this study is to determine the prevalence and prognostic value of
elevated cardiac troponin (cTnT) and its association with clinical characteristics according to
renal function status in patients with stable heart failure.

Methods: In a prospective observational study, 152 consecutive patients from the Heart
Failure Clinic of the INCMNSZ were followed for a period of 42 months. All underwent
clinical evaluation, echocardiography, and determination of body composition by electric
bioimpedance to identify hypervolemia. Concentrations of cTnT were quantified by
immunoassay with electrochemoluminescence and ≥ 0.02 ng/mL levels were considered
elevated. Also glomerular filtration rate (eGFR) was estimated using the Cockcroft-Gault
equation.

Results: Elevated cTnT was significantly associated with increased all-cause mortality in the
observational period even after adjusting for eGFR < 60 mL/min/1.73 m² and clinical findings
such as hypertension, functional class, loop diuretics, angiotensin converting enzyme
inhibitors, pulmonary pressure and hypervolemia in Cox regression analysis with a hazard
ratio of 4.58 (95% confidence interval: 1.84–11.45).

CONCLUSIONS: Heart failure patients with elevated cardiac-specific troponin T are at increased
risk of death independently of the presence of chronic kidney disease.
(Cardiol J 2010;
17, 1: 42-48)