High troponin linked with heightened mortality risk from any cause

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A high level of troponin may signal a heightened risk of death from any cause within the next few years, even in the absence of known or suspected cardiovascular disease (CVD), according to research recently published in the journal Heart.

The findings suggest broader use for the troponin blood test, aside from its role as a test for acute heart attack, said Nick Curzen, professor of interventional cardiology at the University of Southampton in the U.K., in a statement released by the university.

“[The troponin blood test], as distinct from its current role as a test for acute heart attack, may be useful in a much more general way as a snapshot indicator of medium-term mortality in all patients, regardless of whether they are known, or suspected, to have a heart problem,” he said.

The protein troponin is released into the bloodstream during a heart attack. However, high cardiac levels of troponin are often present in hospital patients who don’t have specific signs of a heart attack, but the clinical significance of this observation is unclear.

Curzen and colleagues tracked the survival of 20,000 hospital patients who had a blood test performed for varying reasons and for whom troponin levels were measured. The average age of the patients was 61; 53% were women.

The results, after accounting for factors including age, sex, and kidney function, showed an abnormally high cardiac troponin level was independently associated with a 76% increased risk of death not only from cardiovascular disease but also other causes. The most common cause of death was cancer, followed by cardiovascular disease.

After the researchers excluded deaths that occurred within 30 days of testing (a parameter used to exclude the likelihood of death being associated with the reason for their inpatient stay), the link between cardiac troponin and heightened risk of death persisted, indicating that the association was not driven by a short-term risk of death, the researchers said.

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