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Concentrations of Highly Sensitive Cardiac Troponin-I Predict Poor Cardiovascular Outcomes and Adverse Remodeling in Chronic Heart Failure


Highly sensitive troponin (hsTn) assays may predict cardiovascular (CV) events and left ventricular (LV) remodeling in patients with heart failure (HF). In this study, 99 subjects with LV systolic dysfunction (LVSD) were followed 10 ± 3 months with serial measurement of hsTnI by a novel method. hsTnI was detectable in all subjects and was above the 99th percentile of a normal population in 56.7 %. Supramedian baseline hsTnI concentration was associated with higher-risk clinical features and shorter time-to-first event (p = 0.008). Across serial measurements, more time spent ≤10.9 pg/mL was associated with a lower CV event rate after adjustment (odds ratio (OR) = 0.81; p = 0.008); rising hsTnI also predicted progressive LV remodeling. In conclusion, hsTnI detected significant myocardial necrosis in a majority of patients with chronic HF due to LVSD and when measured serially, provided independent risk information for poor CV outcomes and deleterious LV remodeling.

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Highly sensitive troponin I




Heart failure


Left ventricular


Left ventricular systolic dysfunction


Pro-BNP Outpatient Tailored Chronic Heart Failure Therapy


Amino-terminal pro-B type natriuretic peptide


Transthoracic echocardiogram


Left ventricular ejection fraction


Left ventricular end systolic volume index


Left ventricular end diastolic volume index


Standard deviation


Interquartile range


New York Heart Association


Estimated glomerular filtration rate


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Sources of Funding

This work was supported in part by Singulex, which had no role in data analysis or initial manuscript preparation. Dr. Motiwala was supported by the Dennis and Marilyn Barry Fellowship in Cardiology, Dr. Gaggin is supported in part by the Clark Fund for Cardiac Research Innovation, and Dr. Januzzi is supported in part by the Roman W. DeSanctis Clinical Scholar Endowment.


Dr. Januzzi has received grant support from Roche Diagnostics, Singulex, Critical Diagnostics, Siemens, and BRAHMS and consulting revenue from Novartis, Zensun, Amgen, Radiometer, and Boeringer Ingelheim. All other authors have no conflicts of interest to declare.

Human Subjects/Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

Animal Studies

No animal studies were carried out by the authors for this article.

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Correspondence to James L. Januzzi Jr..

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Associate Editor Daniel P. Judge oversaw the review of this article

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Motiwala, S.R., Gaggin, H.K., Gandhi, P.U. et al. Concentrations of Highly Sensitive Cardiac Troponin-I Predict Poor Cardiovascular Outcomes and Adverse Remodeling in Chronic Heart Failure. J. of Cardiovasc. Trans. Res. 8, 164–172 (2015).

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