High-sensitivity troponin T is detectable in most patients with clinically stable heart failure

Troponin levels are used in the diagnosis of acute coronary syndromes (ACS), however, levels may be elevated in many other conditions. A significant proportion of patients with stable heart failure (HF) have detectable levels of troponin using standard assays, however, the incidence of detectable levels of high-sensitivity troponin T (hsTnT) in HF patients is not extensively studied. As part of a trial assessing vascular function in stable HF patients, 32 subjects had hsTnT levels measured at baseline using a multi-channel analyser (Roche E Module). At baseline, 27 (84.4%) patients had detectable levels of hsTnT (median 13.8 ng/L, range 9.2-21.4): 12 (75%) patients in the non-ischaemic group and 15 (94%) in the ischaemic group. A total of 14 (43.8%) patients had levels above the 99^th percentile of the normal range. The majority of patients with stable HF will have detectable levels of troponin T using new high-sensitivity assays. A significant proportion of these will be above the cut-off point used for diagnosis of ACS. If these patients present to hospital, modest elevations in hsTnT do not necessarily indicate recent ACS, and serial measurements should be undertaken if clinically indicated.