An elevated serum concentration of high-sensitivity cardiac troponin T (≥0.01 ng/ml) was an independent predictor of cardiac mortality (HR 5.85) in patients with nonischemic dilated cardiomyopathy.
Cohort (n=85)
No
Does highly sensitive cardiac troponin T (hs-cTnT) provide better prognostic value than conventional cTnT for predicting cardiac death in patients with nonischemic dilated cardiomyopathy?
Highly sensitive cardiac troponin T is a useful, independent prognostic predictor of cardiac death in patients with nonischemic dilated cardiomyopathy, outperforming conventional cTnT assays.
Effect estimate: HR 5.85 (95% CI 1.66-20.8)
p-value: p=0.006
BACKGROUND: Cardiac troponin T (cTnT) is useful biomarker in patients with chronic heart failure (CHF). However, its clinical use is limited by the low sensitivity of the conventional commercial assay system. Recently, a highly sensitive cTnT (hs-cTnT) assay has become commercially available. METHODS AND RESULTS: To compare the prognostic value of conventional cTnT and hs-cTnT in patients with nonischemic dilated cardiomyopathy (DCM), hemodynamic parameters and the serum levels of conventional cTnT, hs-cTnT and brain natriuretic peptide (BNP) were measured in 85 consecutive CHF patients with nonischemic DCM and then these patients were followed for a mean of 4.1 years. During long-term follow up, there were 20 cardiac deaths. In 85 DCM patients, conventional cTnT was elevated (≥0.03ng/ml) in 4 patients (5%) and hs-cTnT was elevated (≥0.01ng/ml) in 46 patients (54%). In non-survivors (n=20), conventional cTnT was elevated (≥0.03ng/ml) in 2 patients (2%) and hs-cTnT was elevated (≥0.01ng/ml) in 17 patients (85%). In the stepwise multivariate analyses, a high plasma level of BNP (P=0.002), low left ventricular ejection fraction (<30%, P=0.012) and high hs-cTnT (≥0.01ng/ml, P=0.006) were independent significant prognostic predictors, but conventional cTnT (≥0.03ng/ml) was not. CONCLUSIONS: The findings of the present study indicated that a high serum concentration of hs-cTnT is a useful prognostic predictor that is independent of LVEF or BNP in CHF patients with non-ischemic DCM, suggesting that an increased hs-cTnT concentration sensitively reflects ongoing myocardial damage.
Kawahara et al. (2010) conducted a cohort in Nonischemic Dilated Cardiomyopathy (n=85). High-sensitivity cardiac troponin T (hs-cTnT) ≥0.01 ng/ml vs. hs-cTnT <0.01 ng/ml was evaluated on Cardiac death (HR 5.85, 95% CI 1.66-20.8, p=0.006). An elevated serum concentration of high-sensitivity cardiac troponin T (≥0.01 ng/ml) was an independent predictor of cardiac mortality (HR 5.85) in patients with nonischemic dilated cardiomyopathy.