Prognostic value of high‐sensitivity cardiac troponin I in patients with non‐ischaemic heart failure: insights from China

Abstract

Abstract Aims Evidence of the prognostic value of high‐sensitivity troponin in patients with non‐ischaemic heart failure (NIHF) is scarce. This study aimed to assess the predictive value of high‐sensitivity cardiac troponin I (hs‐cTnI) in NIHF patients. Methods Hs‐cTnI was measured at baseline in 650 NIHF patients admitted to the Heart Failure Center. The prognostic value of hs‐cTnI was assessed based on a well‐established model (including age, sex, New York Heart Association class, left ventricular ejection fraction, haemoglobin, sodium, estimated glomerular filtration rate, diabetes mellitus, treatment with angiotensin‐converting enzyme inhibitors or angiotensin II receptor blockers, treatment with β‐blockers, and NT‐proBNP). Results During a median follow‐up of 1036 days, 163 patients died of various causes. In total, 46.92% of patients had high hs‐cTnI (hs‐cTnI >0.011 ng/ml). Over a 3‐year follow‐up, patients with high hs‐cTnI (>0.011 ng/ml) had a 1.54 [95% confidence interval (95% CI) 1.11–2.15] fold higher all‐cause mortality risk than those without. Increasing concertation of hs‐cTnI was also associated with a 23.0% (95% CI 13–33%, per log2 increase) increment risk of all‐cause mortality. The inclusion of hs‐cTnI significantly improved the risk prediction and stratification of all‐cause mortality (integrated discrimination improvement 1.58%, 95% CI 0.38–2.79%, absolute net reclassification improvement 23.41% 95% CI 4.52–44.49%, additive net reclassification improvement 27.8%, 95% CI 9.29–46.3%) of the well‐established model. Conclusions Hs‐cTnI provides significant prognostic value and could further remarkably improve risk stratification and prediction capabilities in NIHF patients.

Keywords

• High‐sensitivity cardiac troponin I
• Heart failure
• Prognosis
• Biomarker