The prognostic role of high-sensitivity cardiac troponin T over time in ischemic and non-ischemic heart failure

Introduction
High-sensitivity cardiac troponin T (hs-cTnT) as a prognostic biomarker can be detected in patients with heart failure (HF). Aim: This study focuses on hs-cTnT to evaluate its prognostic role in ischemic heart failure (IHF) and non-ischemic heart failure (NIHF).

Material and methods
One hundred and sixty patients with HF were divided into IHF and NIHF groups. Hs-cTnT measured at baseline, 2–5 h, 6–24 h and 24 h–7 d after admission was analyzed by generalized estimating equations. Patients were followed up for 1 year at the endpoint events of re-hospitalization for HF and all-cause death that was tested by the Kaplan-Meier method and the Cox regression method.

Results
Hs-cTnT varied significantly over time, first increasing and then decreasing in IHF while showing a continuously elevated trend in NIHF. Patients with hs-cTnT levels > 0.014 ng/ml had a significantly higher re-hospitalization rate compared with those with hs-cTnT levels  0.014 ng/ml (23.7% vs. 7.0%, p < 0.05). Adjusted for age, New York Heart Association class, N-terminal pro-B-type natriuretic peptide, and left ventricular ejection fraction, baseline hs-cTnT was independently associated with re-hospitalization and all-cause death in HF (p < 0.05). Optimal hs-cTnT cut-off of 0.0275 ng/ml was derived to predict the re-hospitalization and death in IHF (AUC = 0.709, 95% CI: 0.561–0.856, sensitivity: 76.9%, specificity: 63.5%, p < 0.05).

Conclusions
Hs-cTnT varying over time is an important risk factor for the prognosis of patients with IHF and NIHF.