TOPLINE

Among individuals with suspected acute coronary syndrome (ACS), persistently elevated high-sensitivity troponin-T (hs-TnT) levels were associated with the highest risk of developing heart failure (HF). Additionally, higher peak hs-TnT levels showed a clear dose-response relationship with the risk for HF.

METHODOLOGY

• Using data from Danish nationwide registries, researchers conducted a cohort study to evaluate the association between high-sensitivity troponin-T levels and the risk for HF among individuals with suspected ACS.
• They analysed data from 26,835 individuals (median age, 64.2 years; 59.5% men) with suspected ACS without a history of HF who underwent serial hs-TnT testing during a hospital admission between 2012 and 2019 and were discharged with a diagnosis of myocardial infarction (38.8%), unstable angina (5.1%), or suspected myocardial infarction or chest pain (56.1%).
• Individuals were grouped based on serial hs-TnT patterns (normal, rising, persistently elevated, or falling), the extent of change in hs-TnT levels (≤ 20%, > 20%-50%, or > 50%), and quartiles of peak hs-TnT levels (≤ 9 ng/L, 10-19 ng/L, 20-263 ng/L, or ≥ 264 ng/L).
• The primary outcome was incident HF, defined as a hospitalisation or outpatient visit for HF, assessed separately during the first 30 days and during days 31-365.
• Participants were followed up for up to 12 months or until the occurrence of HF or death.

TAKEAWAY

• Within the first 30 days, 4.2% of the participants developed HF, and an additional 2.8% developed HF between days 31 and 365.
• Individuals with persistently elevated hs-TnT concentrations had the highest standardised risk for HF, reaching 6.6% during the first 30 days and 4.3% between days 31 and 365, whereas patients with two normal hs-TnT measurements had the lowest risk at 0.3% and 0.4%, respectively.
• Among individuals with persistently elevated hs-TnT levels, the risk for HF increased for those whose hs-TnT levels decreased by > 20%-50%, increased by > 20%-50%, or increased by > 50% between measurements, whereas the risk remained lower for those whose hs-TnT levels changed by ≤ 20%.

IN PRACTICE

"This suggests that this biomarker could be included in risk scores to predict the risk of heart failure in individuals with suspected acute coronary syndrome, irrespectively of their final diagnosis," the researchers wrote.

SOURCE

The study was led by Philip Ahle Erichsen, MD, of Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark. It was published online on August 30 in the International Journal of Cardiology.

LIMITATIONS

The study relied on diagnoses recorded in Danish administrative registries, and hospitals did not use a common assessment protocol. The analysis did not capture symptom presentation, the time from symptom onset to blood sampling, or electrocardiographic findings. The cohort included a relatively high proportion of patients with myocardial infarction, which may have affected the overall risk estimates.

DISCLOSURES

No funding was provided for the study. Some authors disclosed serving on advisory boards or receiving speaker honoraria from multiple pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.