Abstract 17890: High-Sensitivity Troponin-T Predicts Elevated Fibrosis Markers in Adults Aged ≥ 65 Years with Heart Failure
Purpose: Myocyte growth and fibroblast hyperplasia are major determinants of cardiac hypertrophy and heart failure (HF). This study examines whether increases over time in high-sensitive Troponin T (hsTnT) are predictive of elevated fibrosis markers in HF patients and controls.
Methods: hsTnT was measured at baseline and at 3 years follow-up (Roche Elecsys 2010; lower detection limit 3 pg/mL) in a sub-cohort of the Cardiovascular Health Study (N=353; age=74±6 yrs; 52% women). Fibrosis markers (procollagen type I (PIP), type I collagen telopeptide (CITP), and procollagen type III (PIIINP)) were measured at the 3-year follow-up (101 HF patients, 99 controls with traditional risk factors [hypertension, diabetes, or hypercholesterolemia] and 153 controls without these factors). Non-parametric correlations (Spearman's rho) and multivariable linear regression on ln-transformed values were used. Covariates included: demographics, baseline hsTnT, and clinical variables (HF status at follow-up, coronary heart disease, traditional risk factors, creatinine, and presence of major ECG abnormalities). A change (Δ) of ≥20% was used to define a significant increase in hsTnT.
Results: hsTnT was cross-sectionally associated with CITP (rho=0.34) and PIIINP (rho=0.32) at follow-up (p's<0.0001), but not with PIP (rho=-0.01). The Δ hsTnT from baseline to follow-up was predictive of higher CITP (rho=0.21, p=0.0001) and PIIINP (rho=0.14, p=0.009), but not PIP (rho=0.07, p=0.24). These results remained significant in mutivariably adjusted models (CITP p<0.0001; PIIINP p=0.010). A ≥20% increase in hsTnT was more common in HF than controls (p=0.002) and predicted higher CITP levels in HF (p=0.015), but not controls (Figure).
Conclusions: Increases in myocyte injury measured by hsTnT may predict interstitial fibrosis, particularly in HF patients. Early detection of increases in hsTnT may identify patients at risk of myocardial fibrosis and heart failure.
- © 2010 by American Heart Association, Inc.