High-Sensitivity Troponins May Help Identify MASLD Patients at Greater Risk of Death: Study Finds
USA: A new long-term study has highlighted the potential value of high-sensitivity troponins (hs-troponin T and I) in predicting mortality among individuals with metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease (NAFLD).
In their findings published in Alimentary Pharmacology & Therapeutics, the researchers reported that elevated levels of high-sensitivity cardiac biomarkers were significantly linked to an increased risk of both all-cause and cardiovascular-specific mortality, even among individuals without a known history of cardiovascular disease. They noted that each one-standard-deviation increase in hs-troponin T levels corresponded to a 29% rise in overall mortality and a 44% increase in cardiovascular-related deaths, with similar trends observed for hs-troponin I levels.
Understanding the phenotypic characteristics of individuals with MASLD is crucial for identifying those at heightened risk of adverse outcomes. Given that high-sensitivity troponin (hs-troponin) serves as a strong predictor of future cardiovascular events, Donghee Kim, Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California, USA, and colleagues aimed to explore its association with all-cause and cause-specific mortality in individuals with MASLD who had no prior history of cardiovascular disease. They suggest that this approach could help pinpoint vulnerable subpopulations within the MASLD group and improve risk stratification efforts.
For this purpose, the researchers utilized data from the National Health and Nutrition Examination Survey (NHANES) spanning 1999 to 2004 and linking it to mortality records through 2019. They employed Cox regression models to examine how high-sensitivity troponin levels were associated with all-cause and cause-specific mortality in individuals diagnosed with MASLD who had no history of cardiovascular disease.
The study led to the following findings:
- Over a median follow-up of 17.5 years, individuals with MASLD and elevated hs-troponin T levels showed a progressively higher risk of both all-cause and cardiovascular-related death.
- These associations remained significant even after accounting for various demographic, clinical, lifestyle, and metabolic factors.
- Each one-standard deviation increase in hs-troponin T levels was linked to a 29% rise in all-cause mortality (HR: 1.29).
- The same increase was associated with a 44% rise in cardiovascular mortality (HR: 1.44).
- There was a similar trend between hs-troponin I levels and cardiovascular mortality across three different assays.
- There was no significant link between hs-troponin levels and cancer-related mortality.
"Screening for high-sensitivity troponin T or I in individuals with MASLD may help pinpoint subgroups at greater risk of future mortality, particularly from cardiovascular causes—even in those without a prior diagnosis of cardiovascular disease. This approach could support earlier identification and targeted intervention in high-risk patients," the authors concluded.
Reference:
Kim, D., Danpanichkul, P., Wijarnpreecha, K., Cholankeril, G., & Ahmed, A. Association of High-Sensitivity Troponins in Metabolic Dysfunction-Associated Steatotic Liver Disease With All-Cause and Cause-Specific Mortality. Alimentary Pharmacology & Therapeutics. https://doi.org/10.1111/apt.70128
