Significance of high-sensitivity cardiac troponin T in hypertrophic cardiomyopathy

Abstract

Objectives: This study investigated the significance of the serum high-sensitivity cardiac troponin T (hs-cTnT) marker for prediction of adverse events in hypertrophic cardiomyopathy (HCM).

Background: Although serum cardiac troponins as sensitive and specific markers of myocardial injury have become well-established diagnostic and prognostic markers in acute coronary syndrome, the usefulness of hs-cTnT for prediction of cardiovascular events in patients with HCM is unclear.

Methods: We performed clinical evaluation, including measurements of hs-cTnT in 183 consecutive patients with HCM.

Results: Of 183 HCM patients, 99 (54%) showed abnormal hs-cTnT values (>0.014 ng/ml). During a mean follow-up of 4.1 ± 2.0 years, 32 (32%) of the 99 patients in the abnormal hs-cTnT group, but only 6 (7%) of 84 patients with normal hs-cTnT values, experienced cardiovascular events: cardiovascular deaths, unplanned heart failure admissions, sustained ventricular tachycardia, embolic events, and progression to New York Heart Association functional class III or IV status (hazard ratio [HR]: 5.05, p < 0.001). Abnormal hs-cTnT value remained an independent predictor of these cardiovascular events after multivariate analysis (HR: 3.23, p = 0.012). Furthermore, in the abnormal hs-cTnT group, overall risk increased with an increase in hs-cTnT value (HR: 1.89/hs-cTnT 1 SD increase in the logarithmic scale, 95% confidence interval: 1.13 to 3.15; p = 0.015 [SD: 0.59]).

Conclusions: In patients with HCM, an abnormal serum concentration of hs-cTnT is an independent predictor of adverse outcome, and a higher degree of abnormality in hs-cTnT value is associated with a greater risk of cardiovascular events.

Keywords: 2-D; CI; FS; HCM; HR; ICD; IDI; LV; LVEDD; LVESD; MRI; NYHA; New York Heart Association; VT; biomarker; confidence interval; fractional shortening; hazards ratio; high-sensitivity cardiac troponin T; hs-cTnT; hypertrophic cardiomyopathy; implantable cardioverter-defibrillator; integrated discrimination improvement; left ventricular; left ventricular end-diastolic diameter; left ventricular end-systolic diameter; magnetic resonance imaging; prognosis; two-dimensional; ventricular tachycardia.