Abstract 16297: High Sensitivity Cardiac Troponin T Reflects Presence of Left Ventricular Hypertrophy and Diastolic Dysfunction and Predicts Incidence of Cardiac Events
Background: High Sensitivity Cardiac Troponin T (Hs-TNT) is a reliable biomarker in diagnosis of acute coronary syndrome. Recently, it has been also reported that high Hs-TNT predicts cardiovascular event even in general population, however, the mechanism of the poor prognosis of subjects with high Hs-TNT has not been clarified.
Methods and results: 228 consecutive subjects without obvious cardiovascular disease who came to our hospital for health check were enrolled in our study. Hs-TNT, NT-proBNP, classical coronary risk factors, estimated glomerular filtration rate (eGFR) were examined. Cardiac structure and function were also evaluated by echocardiography. Subjects were divided into two groups according to Hs-TNT level; high Hs-TNT group (≧0.014ng/ml, n=44) and low Hs-TNT group (<0.014ng/ml, n=184). Occurrence of major clinical cardiovascular events such as death, admission for heart failure, coronary artery disease, and stroke were investigated. During the follow up period (mean 187 days), incidence of major clinical cardiac events was significantly higher in high Hs-TNT group compared with low Hs-TNT group (23% vs 14%, p=0.0091), although there was no difference in cardiac mortality between the two group. Compared with low Hs-TNT group, high Hs-TNT group had higher age (p<0.001), lower eGFR (p<0.001) and higher NT-proBNP (p<0.001). In echocardiographic data, E/e’ was higher (p=0.02) and left ventricular mass index (LVMI) was higher in high Hs-TNT group compared with low Hs-TNT group (p<0.001), whereas left ventricular ejection fraction was comparable between the two group. Univariate analylsis showed the positive correlation between Hs-TnT and LVMI (r=0.282, p<0.0001). In multivariable analysis, this association was still significant after adjustment for age, sex, coronary risk factor, eGFR, NT-proBNP (p=0.0034).
Conclusion: Cardiac event rate was significantly higher in subjects with high Hs-TNT even in short time period, indicating that Hs-TNT is a useful biomarker in predicting the incidence of cardiac events even in subjects without obvious cardiovascular disease. Subclinical cardiac damage such as left ventricular hypertrophy as well as diastolic dysfunction may be involved in the poor prognosis in subjects with high Hs-TNT.
- © 2013 by American Heart Association, Inc.