Abstract

AIM: To study the association of high sensitivity troponin T (hsTnT) with incident heart failure, and implications for its use in prediction models. METHODS AND RESULTS: The British Regional Heart Study of 3852 men aged 60-79 without baseline HF (3165 without baseline CHD) was followed up for a median of 12.6 years, during which 295 incident cases of HF occurred (7.7%). A 1 standard deviation increase in log-transformed hsTnT was associated with a higher risk of incident HF after adjusting for classical risk factors (HR 1.58 [95% CI 1.42, 1.77]) and after additional adjustment for NT-proBNP (HR 1.34 [95% CI 1.19, 1.52]). The strength of the association between hsTnT and incident HF did not differ by strata of other risk factors. A hsTnT concentration of <5ng/L had a sensitivity of 99.7% (95%CI 98.1-99.9%) and a specificity of 3.4% (95%CI 2.8%-4.0%). A risk prediction model including classic risk factors and NT-proBNP yielded a c-index of 0.791, but addition of hsTnT did not further improve prediction (p=0.28). CONCLUSIONS: Elevated hsTnT is consistently associated with risk of HF in older men. HF rarely occurs over 12 years when baseline hsTnT is below the limit of detection. hsTnT measurement, however, does not improve HF prediction in a model already containing NT proBNP.