What Is the Clinical Utility of Cardiac Troponins in Heart Failure? Are They Modifiable Beyond Their Prognostic Value?

Curr Heart Fail Rep. 2023 Feb;20(1):33-43. doi: 10.1007/s11897-023-00588-z. Epub 2023 Jan 31.

Abstract

Purpose of review: To review the role of cardiac troponin (cTn) for prognosis in acute and chronic heart failure, and for predicting heart failure; and to explore the association between troponin and response to heart failure therapies, with an eye toward a possible role for troponin in a personalized approach to heart failure management, beyond prognosis.

Recent findings: A number of therapies, including the neprilysin inhibitor sacubitril/valsartan and sodium-glucose cotransporter-2 inhibitors, have recently been shown to improve outcomes in heart failure patients. Most studies suggest that these agents improve outcomes regardless of baseline cTn concentration, but have greater absolute benefit among patients with highest cTn and baseline risk. Troponin is prognostic across the heart failure spectrum, but whether it can significantly help with heart failure prevention and with tailoring and guiding heart failure treatments and interventions remains unknown.

Keywords: Heart failure; Interaction; Monitoring; Outcomes; Troponin.

Publication types

  • Review

MeSH terms

  • Aminobutyrates
  • Heart Failure* / drug therapy
  • Humans
  • Prognosis
  • Sodium-Glucose Transporter 2 Inhibitors* / therapeutic use
  • Tetrazoles
  • Troponin

Substances

  • Aminobutyrates
  • Sodium-Glucose Transporter 2 Inhibitors
  • Tetrazoles
  • Troponin