High-Sensitivity Cardiac Troponin Prognostic in Chronic CAD

A UK prospective cohort study in patients with symptoms suggestive of stable angina suggested that cardiac troponin predicts risk of myocardial infarction or cardiovascular death independent of cardiovascular risk factors and disease severity. The study included 4,240 patients (mean age 66 years, 33% female), coronary artery disease (CAD) was identified in 3,888 (92%) with 255 (6%) primary outcome events (myocardial infarction or cardiovascular death) during a median follow-up of 2.4 years. In patients with CAD, troponin concentrations were 2-fold higher in those with an event compared with those without (6.7 ng/L vs 3.3 ng/L). Troponin concentrations were associated with the primary outcome after adjusting for cardiovascular risk factors and CAD severity (adjusted HR: 2.3, log₁₀ troponin). A troponin concentration >10 ng/L identified patients with a 50% increase in the risk of myocardial infarction or cardiovascular death. The findings suggest that cardiac troponin testing could help to guide the management of patients with chronic CAD, especially in higher-risk patients. Cardiac troponin has been used for risk stratification of patients with acute coronary syndromes. Source: https://www.jacc.org/