Troponin, BNP may predict development of congestive heart failure
Troponin and B-type natriuretic peptide (BNP) as screening tools demonstrate potential in detecting cardiovascular disease (CVD)-free individuals at increased risk of developing congestive heart failure (CHF) in subsequent years, according to a recent study. Moreover, these markers appear to have lesser roles for predicting subsequent myocardial infarction (MI) or stroke.
The study included 2,171 men aged 55–69 years, of whom 1,279 had no clinical history or evidence of CVD at baseline. All men contributed fasting blood samples, which were assayed for novel biomarkers.
During an average follow-up of 13 years, a total of 584 MIs, 313 strokes and 261 episodes of CHF not associated with acute MI occurred.
Proportional hazards regression models showed that in the subgroup of men who had no clinical history or evidence of CVD at baseline, those in the top third (high) of the distributions of troponin and BNP were three times as likely as those in the bottom third (low) to develop CHF as a first event after adjustment for all conventional risk factors (troponin: subhazard ratio [SHR], 3.37; 95 percent CI, 1.39–8.14; BNP: SHR, 3.23; 1.45–7.23).
Additionally, individuals with high vs low levels of troponin and BNP had moderate increases in risks of acute MI (troponin: SHR, 1.63; 1.10–2.41) and stroke (BNP: SHR, 1.75; 1.06–2.88).
Chronic heart failure is a leading cause of mortality and morbidity, and certain markers such as BNP have been shown to help predict subsequent heart failure in individuals without a history of prior cardiovascular disease (CVD).
The present analysis was limited by the small number of first events of CHF in the subgroup of men who were free of CVD at baseline, as well as the possibility that ischaemia could have resulted in clinical symptoms, which might have occurred during the follow-up period.