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, according to a study that will appear in the December 8 issue of JAMA. The study is being released early online because it will be presented at the American Heart Association's annual meeting.
"Older adults comprise the majority of new-onset heart failure (HF) diagnoses, but traditional risk-factor prediction models have limited accuracy in this population to identify those at highest risk for hospitalization or death," according to background information in the article. Blood-based biomarkers, including troponins, have been advocated for use as supplemental to clinical risk factors to identify older adults at high risk for adverse cardiovascular outcomes, but studies examining the prognostic value of these markers have reported inconsistent results.
Prior studies have used standard troponin assays that are only able to detect circulating troponin levels in a small proportion of individuals. Recently, a highly sensitive cardiac troponin T assay has been developed, designed to improve accuracy. "This assay has detected circulating cTnT in almost all patients with chronic HF or ischemic heart disease and provides independent prognostic information with respect to HF admission and cardiovascular death in these patients," the authors write.
Christopher R. deFilippi, M.D., of the University of Maryland School of Medicine, Baltimore, and colleagues examined the ability to detect a measurable cTnT concentration in older adults using the highly sensitive cTnT assay and whether higher concentrations would be associated with a greater risk of new-onset HF and cardiovascular death. The researchers analyzed data from the Cardiovascular Health study and included 4,221 community-dwelling adults ages 65 years or older without
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