Prognostic Value of High-Sensitivity Troponin T in Chronic Heart Failure

Clinical question: What is the prognostic relevance of hs-troponin in patients with chronic heart failure?

What is known: Most patients with chronic heart failure have detectable troponin concentrations when evaluated by high-sensitivity assays.

Methods: This is an individual patient-data meta-analysis that searched the terms were “troponin” AND “heart failure” OR “cardiac failure” OR “cardiac dysfunction” OR “cardiac insufficiency” OR “left ventricular dysfunction” in Medline, EMBASE, Cochrane Library, and Scopus. 

Results/Implications: In this individual patient data meta-analysis on high-sensitivity troponins and prognosis in chronic heart failure, data were retrieved from 10 studies, corresponding to 11 cohorts and 9289 patients, all with available high-sensitivity troponin T (hs-TnT) data.  Over a median 2.4-year follow-up, hs-TnT was an independent predictor of all-cause and cardiovascular death, and cardiovascular hospitalization.

Bottom-line: In patients with chronic heart failure, high-sensitivity troponin T is a strong and independent predictor of all-cause and cardiovascular mortality, and of hospitalization for cardiovascular causes, as well. This biomarker then represents an additional tool for prognostic stratification.