Biomarker predicts heart failure risk

A new test for a blood biomarker can more accurately predict risk of heart failure (HF) in elderly people than existing models, research has shown.

Heart failure: risk factor prediction models have limited accuracy (Photograph: SPL)

Researchers from the University of Maryland School of Medicine found raised levels of the protein cardiac troponin T (cTnT) were linked to increased risk of HF and death.

Measurements of cTnT alongside the NICE-recommended test for serum BNP (N-terminal pro-B-type natriuretic peptide, or NT-proBNP) may improve HF risk assessment in elderly patients, the researchers claimed.

Traditional risk-factor prediction models for HF and cardiovascular death have limited accuracy in older adults, the authors said.

The recent development of a highly sensitive test for cardiac proteins has presented a new and potentially more accurate measure of risk, they said.

A team led by Dr Christopher deFilippi assessed the predictive powers of the test in 4,221 adults aged 65 years or older without prior HF.

The group's cTnT levels were analysed at baseline. This was repeated in two-thirds of participants after two to three years.

Researchers then followed up this group after almost 12 years. There were 1,279 cases of HF and 1,103 cardiovascular deaths in this time.

The risk of either event was associated with higher cTnT concentrations. Risk was relative to cTnT levels at baseline, irrespective of the absolute initial value and other clinical risk factors.

The study authors said the new test increased the proportion of older adults with detectable cTnT levels 10-fold.

Unlike existing methods, the new test enables a gradient of risk to be estimated, and the significance of changing cTnT levels to be examined, they added.

The authors concluded that findings from this study and previous work into BNP testing 'suggest that serial measurements of both NT-proBNP and cTnT may improve risk assessment in elderly individuals'.

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