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Blood Biomarker Test Assesses Heart Failure Risk

A new and highly sensitive assay for cardiac troponin T (cTnT), a cardiac-specific protein, may help to predict the development of heart failure or cardiovascular death in older adults.

Certain measures of the blood biomarker cardiac troponin T (cTnT), a cardiac-specific protein, using a highly sensitive test, are associated with the development of heart failure or cardiovascular death in older adults.  Christopher R. deFilippi, from the University of Maryland School of Medicine (Maryland, USA), and colleagues analyzed data from the Cardiovascular Health study and included 4,221 community-dwelling adults, ages 65 years and older, without prior heart failure and who had cTnT measured using the highly sensitive assay at the beginning of the study, and repeated after 2 to 3 years.  During a median (midpoint) follow-up of 11.8 years from the initial cTnT measurement, 1,279 participants experienced new-onset heart failure and 1,103 cardiovascular deaths occurred, with a greater risk of both end points associated with higher cTnT concentrations. Analysis indicated that for participants with measurable cTnT levels at the beginning of the study, an increase of more than 50% was associated with an increased risk of heart failure and a greater risk of cardiovascular death.  In contrast, a decrease of more than 50% was associated with a risk-factor adjusted lower risk of heart failure and lower risk of cardiovascular death compared, as with those participants with 50% or less change. The team concludes that: “In this cohort of older adults without known [heart failure], baseline cTnT levels and changes in cTnT levels measured with a highly sensitive assay were significantly associated with incident [heart failure] and cardiovascular death.”

Christopher R. deFilippi; James A. de Lemos; Robert H. Christenson; John S. Gottdiener; Willem J. Kop; Min Zhan; Stephen L. Seliger.  “Association of Serial Measures of Cardiac Troponin T Using a Sensitive Assay With Incident Heart Failure and Cardiovascular Mortality in Older Adults.”  JAMA, Nov 2010; doi:10.1001/jama.2010.1708.

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