Serial measure of cardiac troponin T levels for prediction of clinical events in decompensated heart failure

Abstract

Background: This study determined whether serial determinations of cardiac troponin T (cTnT) in decompensated heart failure (HF) are predictive of clinical events (death, need for readmission for new episode of HF decompensation, or both) during 1 year of follow-up.

Methods and results: Sixty-two patients with decompensated HF were enrolled in this cohort. The first measurement of cTnT (cTnT1) was from a blood sample drawn within 4 days of hospital admission; the second measurement (cTnT2) was on blood obtained 7 days later. Forty-nine clinical events (16 deaths, 10 readmissions, 23 combined readmission and deaths) occurred during the follow-up. The independent predictors of clinical events were: cTnT1>.020 ng/mL (P<.050), cTnT2>.020 ng/mL (P<.050), and serum sodium<135 mEq/L (P<.050). Based on levels of cTnT1 and cTnT2>.020 ng/mL (+) or </=0.020 ng/mL(-), patients were divided into 2 groups: group 1 (cTnT1-, cTnT2- or cTnT1+, cTnT2-), group 2 (cTnT1-, cTnT2+ or cTnT1+, cTnT2+). Group 2 patients had higher rates of death (45.0% versus 71.4%, P<.050), hospital readmission (35.0% versus 61.9%, P<.050), and clinical events (55.0% versus 90.5%, P<.010) than group 1 patients.

Conclusions: Persistently increased cTnT levels (>.020 ng/mL) are predictive of higher rates of death and hospital readmission for decompensated HF.