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  • Serial hs Troponin...

Serial hs Troponin assessment may further refine risk-assessment in patients post ACS: JAMA study

Written By : dr. Abhimanyu Uppal |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2022-10-27T12:45:43+05:30  |  Updated On 27 Oct 2022 2:26 PM IST
Serial hs Troponin assessment may further refine risk-assessment in patients post ACS: JAMA study
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An association between single measures of high-sensitivity troponin (hsTn) and future cardiovascular events in patients with chronic coronary syndromes have been shown previously. However, limited data exist regarding the association between changes in serial values of hsTn and subsequent cardiovascular events in this patient population. Addressing this lacunae, a recent study published in JAMA cardiology has shown the role of serial hsTnT assessment in future risk stratification of patients with established atherosclerosis. This may be useful to inform decision-making for therapies.

The present study is a secondary analysis of the IMPROVE-IT study which established that single measurements of hsTnT 1 month after stabilization post-ACS were associated with a risk of recurrent cardiovascular events.

In the current analysis of this cohort, authors Patel et al have evaluated whether serial assessment of hsTnT may further refine risk stratification. The current biomarker substudy includes the 6035 participants consenting to the biomarker substudy with available hsTnT at months 1 and 4.

The outcomes of interest were cardiovascular death, myocardial infarction (MI), stroke, or hospitalization for heart failure (HHF). Associations of absolute and relative changes in hsTnT between month 1 and month 4 as a function of the starting month 1 hsTnT and the composite outcome were examined using landmark analyses.

The study's main finding is that increases or decreases in hsTnT from month 1 to month 4 were associated with significantly higher or lower adjusted risk of cardiovascular events, respectively, across the range of starting month 1 hsTnT values.

Moreover, the magnitude of change in hsTnT was associated with a gradient of risk of cardiovascular events. Of all post-ACS patients, authors found that two-thirds had overall stable hsTnT concentration from month 1 to month 4 (absolute change of less than 3 ng/L).

For the remaining one-third with a dynamic change, the findings illustrate that the magnitude of risk associated with changes in hsTnT are proportionate to the overall magnitude of change from baseline, such that larger increases in hsTnT were associated with higher risk for subsequent events.

These findings suggest a role for the application of hsTnT for disease monitoring in patients with chronic coronary syndromes, where serial measures may be used to provide a continuous assessment of future cardiovascular risk.

Source: JAMA Cardiology: doi:10.1001/jamacardio.2022.3627

risk stratificationacute coronary syndromebiomarker
dr. Abhimanyu Uppal
dr. Abhimanyu Uppal

    MBBS, MD , DM Cardiology

    Dr Abhimanyu Uppal completed his M. B. B. S and M. D. in internal medicine from the SMS Medical College in Jaipur. He got selected for D. M. Cardiology course in the prestigious G. B. Pant Institute, New Delhi in 2017. After completing his D. M. Degree he continues to work as Post DM senior resident in G. B. pant hospital. He is actively involved in various research activities of the department and has assisted and performed a multitude of cardiac procedures under the guidance of esteemed faculty of this Institute. He can be contacted at editorial@medicaldialogues.in.

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

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