Prognostic significance of high-sensitivity cardiac troponin in patients with heart failure with preserved ejection fraction

Abstract

The aim of this study was to investigate the prognostic significance of high-sensitivity troponin T (hs-TnT) in patients with heart failure (HF) with preserved ejection fraction (HFpEF). We enrolled consecutive patients admitted to Shinshu University Hospital for HF treatment between July 2014 and March 2017 and stratified them into HF with reduced ejection fraction and HFpEF groups (left ventricular ejection fraction, < 50% and ≥ 50%, respectively). Hs-TnT was evaluated at discharge, and patients were prospectively monitored for all-cause mortality, non-fatal myocardial infarction, stroke, and HF hospitalization. In 155 enrolled patients (median age 76 years), during a median follow-up of 449 days, 60 experienced an adverse event. Hs-TnT was significantly higher in patients with adverse events than in those without in HFpEF (p = 0.003). Hs-TnT did not significantly correlate with age, sex, hemoglobin, albumin, eGFR, or BNP. In Kaplan–Meier analysis, high hs-TnT predicted a poor prognosis in HFpEF (p = 0.003). In multivariate Cox regression analysis, hs-TnT levels independently predicted adverse events in HFpEF (p = 0.003) after adjusting for age and eGFR [HR, 1.015 (95% CI, 1.005–1.025), p = 0.004], and age and BNP [HR 1.016 (95% CI 1.005–1.027), p = 0.005]. Elevated hs-TnT at discharge predicted adverse events in HFpEF.