Determinants of high sensitivity troponin T concentration in ischemic heart failure versus non-ischemic heart failure

Introduction: High sensitivity troponin T (hs-TnT) represents a useful biomarker for early detection of myo-cardial injury. There is recent evidence regarding the usefulness of this biomarker as a prognostic factor in heart failure (HF). Still, hs-TnT concentration can be influenced by different factors in ischemic HF and in non-ischemic HF.
Methods: HF patients hospitalized consecutively in the Cardiology Clinic of Colentina Clinical Hospital from January 2011 to December 2014 were screened for this study. Patients with hsTnT evaluation on ad-mission were included in our sample. Depending on the ethiology of heart failure patients were divided in 2 groups: ischemic and non-ischemic. Patients with acu-te coronary syndromes, pulmonary embolisms, and in hospital mortality were excluded. Clinical, laboratory and echocardiographic parameters were recorded for all patients on admission. Survival status was assessed in June 2018.
Results: Our sample consisted of 371 HF patients, 46.9% with ischemic HF. In the subgroup with ische-mic HF the mean age was 71.1±10.5 years and the me-dian value for hs-TnT was 15 pg/mL [IQR 9.5-27.2]. Patients with decompensated HF (p=0.004), NYHA class IV (p=0.004), chronic kidney disease (p=0.004) and atrial fibrillation (p=0.005) had significantly hi-gher values of hs-TnT. In the subgroup with non-is-chemic HF the mean age was 73.6±9.9 years and the median value for hs-TnT was 17.1 pg/mL [IQR 10.0-29.3]. hs-TnT concentration was significantly higher for those with decompensated HF (p=0.002), but was not influenced by NYHA class, chronic kidney disease or atrial fibrillation. In both ischemic HF and non-is-chemic HF subgroups hs-TnT directly correlated with age (r=0.270, p<0.001, respectively r=0.299, p<0.001), length of hospital stay (r=0.260, p=0.001, respectively r=0.358, p<0.001), glomerular filtration rate (r=0.245, p=0.001, respectively r=0.408, p<0.001), uric acid (r=0.315, p<0.001, respectively r=0.394, p<0.001), NT-proBNP (r=0.520, p<0.001, respectively r=0.536, p<0.001) and left ventricle ejection fraction (r=0.309, p<0.001, respectively r=0.449, p<0.001).
Conclusions: High concentration of hs-TnT is an indi-cative of multifactorial affliction for both ischemic and non-ischemic HF. Severity of HF, presence of chronic kidney disease and atrial fibrillation have a bigger im-pact on hs-TnT concentration for patients with ische-mic HF.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)