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

Journal of Cardiovascular Translational Research volume 8, pages 164–172 (2015)Cite this article

Abstract

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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Abbreviations

hsTnI:

Highly sensitive troponin I

CV:

Cardiovascular

HF:

Heart failure

LV:

Left ventricular

LVSD:

Left ventricular systolic dysfunction

PROTECT:

Pro-BNP Outpatient Tailored Chronic Heart Failure Therapy

NT-proBNP:

Amino-terminal pro-B type natriuretic peptide

TTE:

Transthoracic echocardiogram

LVEF:

Left ventricular ejection fraction

LVESVi:

Left ventricular end systolic volume index

LVEDVi:

Left ventricular end diastolic volume index

SD:

Standard deviation

IQR:

Interquartile range

NYHA:

New York Heart Association

eGFR:

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.

Disclosures

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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Authors and Affiliations

  1. Division of Cardiology, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Shweta R. Motiwala

  2. Division of Cardiology, Massachusetts General Hospital, Boston, MA, 02114, USA

    Hanna K. Gaggin, Parul U. Gandhi, Arianna Belcher, Rory B. Weiner, Aaron L. Baggish & Jackie Szymonifka

  3. Massachusetts General Hospital, Yawkey 5984, Boston, MA, 02114, USA

    James L. Januzzi Jr.

Authors
  1. Shweta R. Motiwala
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  2. Hanna K. Gaggin
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  3. Parul U. Gandhi
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  4. Arianna Belcher
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  5. Rory B. Weiner
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  6. Aaron L. Baggish
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  7. Jackie Szymonifka
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  8. James L. Januzzi Jr.
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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). https://doi.org/10.1007/s12265-015-9618-4

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  • DOI: https://doi.org/10.1007/s12265-015-9618-4

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