Abstract 13209: High Sensitivity Troponin T Levels are Reduced by Beta Blocker Treatment in Heart Failure Patients: First Prospective Clinical Study of Prevention of Subclinical Injury in Heart Failure
Background: β-blocker treatment improves survival, morbidity and left ventricular ejection fraction (LVEF) in patients with systolic heart failure (HF). Cardiac troponin T levels measured by high-sensitivity assays (hsTnT) predict clinical outcomes in HF; however it is unknown whether β-blocker treatment can prevent subclinical myocardial injury or affect hsTnT levels in patients with HF.
Methods: HsTnT levels were measured at baseline and at 6 months after randomization to treatment with carvedilol or metoprolol succinate in 22 β-blocker naïve HF patients with LVEF≤35% at baseline. Data were compared by paired t-testing.
Results: Mean age of the patients was 61±9 years, and LVEF was 22.4 ±7.2%. 73% of patients were with NYHA II; and 27 % NYHA III HF. 46% of patients had CAD, 86% hypertension and 32% diabetes mellitus. All patients had detectable hsTnT levels at baseline, whereas only 9% had abnormal troponin-I levels by conventional testing. Although there was no significant change in conventional TnI levels, β-blocker treatment was associated with a significant decrease in hsTnT levels (p=0.03, Table). In patients with ≥10% improvement in LVEF with β-blocker treatment; hsTnT levels were significantly lower at 6 months (Table). Those without ≥10% improvement in LVEF had no significant changes in hsTnT; and had higher levels at baseline and at six months.
Conclusion: This is the first study demonstrating a reduction in hsTnT levels with treatment;namely with β-blocker therapy in systolic HF. Furthermore, improvement in LVEF with β-blocker treatment was associated with a significant reduction in hsTnT levels. These findings underline the need to explore prevention of cardiac injury as a potential mechanism of improvement in LV function; and that a favorable change in hsTnT levels can be a surrogate marker to identify responders to β-blocker therapy or potentially to other therapies.
- © 2013 by American Heart Association, Inc.