Researchers at Brigham and Women’s Hospital (BWH) claim that a marker generally used to assess risks of cardiac arrest in patients can also be used to determine the possibility in stable patients who are prone to developing cardiac illness. The test is much more complex as compared to current methods used in the US, revealing critical information about patients with type 2 diabetes, stable heart diseases and coronary revascularization.
The Study: Measuring Levels Of Troponin To Predict Risk Of Cardiac Events
Lead author Brendan Everett, MD, MPH from BWH’s Divisions of Cardiovascular Medicine and Preventive Medicine, along with colleagues measured the blood concentrations of troponin in 2,200 patients suffering from type 2 diabetes and stable heart disease. A high-sensitivity electrochemiluminescence assay, currently used in Europe, was used to make the assessment. It was seen that almost 40 percent of the patients had abnormal levels of troponin.
Five years later, 27 percent of the patients who had abnormal levels of troponin died from a cardiac arrest, such as a heart attack or stroke. The 13 percent with normal concentrations of troponin did not suffer such fate. This led to the observation that, patients with elevated concentrations of troponin are twice as likely to die from a cardiac event as compared to those with normal concentrations.
Moreover, half of the study participants received a significant therapeutic intervention termed coronary revascularization – a procedure that involves opening the coronary arteries using stents or bypass graft surgery. This procedure is regularly used in patients with elevated levels of troponin or after a heart attack. Observations revealed that the technique did not appear to lower the risk of cardiac events and related deaths in stable patients, and neither did it reduce the levels of troponin.
Highlighting The Significance Of The Findings
Everett explained that circulating troponin had always been associated with heart muscle injury – the causes of this injury were unclear. It is often interpreted that elevated levels of troponin indicate an ongoing heart attack, which is often treated using coronary revascularization. However, the results of this study indicate that such techniques do not reduce or improve the risk of future heart attacks or death, and alternative strategies are required to improve prognosis in high-risk patients.
“This test was able to identify patients at increased risk of heart attack, heart failure, or death, even after we accounted for other patient characteristics and risk factors. If we can understand what causes the abnormal troponin, we may be able to identify new strategies to treat this group of high-risk patients.” The findings were published in The New England Journal of Medicine.