Longitudinal hs-cTnT concentration and cumulative exposure are strongly associated with mortality (HR ~1.8) and major adverse cardiac events in heart transplant recipients.
Does longitudinal measurement of high-sensitivity cardiac troponin T predict mortality and major adverse cardiac events in adult heart-transplant recipients?
Longitudinal monitoring of high-sensitivity cardiac troponin T provides independent prognostic value for mortality and major adverse cardiac events in heart transplant recipients, outperforming single baseline measurements.
Background Cardiac troponin T is associated with mortality in heart transplantation recipients, but the association between its longitudinal measurements and clinical outcomes has not been evaluated. This study aimed to determine whether 3 parameterizations of serial hs‐ cTnT (high‐sensitivity cardiac troponin T)—instantaneous concentration, temporal trend, and cumulative exposure—are associated with clinical outcomes in this population. Methods In a retrospective analysis, 222 heart transplantation recipients (median age 50 years, 86% men) who survived >30 days post transplant were included. Joint models were used to analyze the association between longitudinal hs‐ cTnT and the primary outcome of all‐cause mortality and the secondary outcome of major adverse cardiac events. Results Over a median follow‐up of 2.3 years, 32 deaths and 41 major adverse cardiac events occurred. Both instantaneous hs‐ cTnT concentration (hazard ratio HR, 1.85 95% CI, 1.48–2.31; P <0.001) and cumulative hs‐ cTnT exposure ( HR, 1.80 95% CI, 1.38–2.37; P <0.001) were strongly associated with mortality. The temporal trend of hs‐ cTnT was significantly associated with mortality after adjustment for donor and recipient factors. Similarly, instantaneous concentration and cumulative exposure were associated with major adverse cardiac events incidence (both P <0.05). In contrast, baseline hs‐ cTnT lost its significant association with outcomes after multivariable adjustment. Conclusions Longitudinally measured hs‐ cTnT is independently associated with mortality and major adverse cardiac events in heart transplant recipients.
Cao et al. (2026) studied this question. Longitudinal hs-cTnT concentration and cumulative exposure are strongly associated with mortality (HR ~1.8) and major adverse cardiac events in heart transplant recipients.