Serial high-sensitivity troponin-T and risk of heart failure in individuals with suspected acute coronary syndrome.

Authors

Philip Ahle Erichsen, Majid Afzal, Christina Byrne, Johanna Maria Christina Frary, Carlo Alberto Barcella, Muthiah Vaduganathan, Anna Meta Dyrvig Kristensen, Massar Omar, Monija Mrgan, Filip Søskov Davidovski, Rasmus Bo Hasselbalch, Kanyaw Kader, Maria Hang Xuan Pham, Marija Todorovic Markovic, Arman Qamar, Julia Frangeskos, Roxana Mihaela Popescu, Tarek Bekfani, Kaveh Hosseini, Tor Biering-Sørensen, Morten Schou, Lars Køber, Gunnar H Gislason, Mikkel Porsborg Andersen, Christian Torp-Pedersen, Kristian H Kragholm, Deepak L Bhatt, Manan Pareek

Published in

International journal of cardiology. Pages 134748. Aug 30, 2026. Epub Aug 30, 2026.

Abstract

To investigate the association between serial high-sensitivity cardiac troponin-T (hs-TnT) concentrations and subsequent heart failure in individuals presenting with suspected acute coronary syndrome (ACS).
Utilizing Danish nationwide registries, we identified individuals without known heart failure who underwent serial hs-TnT assessment for suspected ACS between 2012 and 2019. Individuals were categorized based on the hs-TnT concentration patterns from the first to the second measurement (normal, rising, persistently elevated, or falling), the extent of hs-TnT concentration change (≤20%, >20 to 50%, or > 50%), and quartiles of peak hs-TnT levels (≤9 ng/l, 10-19 ng/l, 20-263 ng/l, and ≥ 264 ng/l). Standardized absolute and relative risks of incident hospitalization or outpatient contact for heart failure were computed using cause-specific multivariable Cox regression with average treatment effect modeling. Of 26,835 individuals, 38.9% received a discharge diagnosis of myocardial infarction, 5.1% of unstable angina, and 56.1% of suspected myocardial infarction or chest pain. Within the initial 30 days, 1122/26,835 (4.2%) persons received a heart failure diagnosis, with an additional 707/25,085 (2.8%) diagnosed between days 31-365. Subjects with two normal hs-TnT values exhibited the lowest standardized absolute risk (0-30 days: 0.3%; 31-365 days: 0.4%), while those with persistently elevated concentrations demonstrated the highest risk (0-30 days: 6.6%; 31-365 days: 4.3%). Heart failure risk also exhibited a significant, positive association with peak hs-TnT concentration.
In individuals presenting with suspected ACS, persistent hs-TnT elevation was associated with the highest risk of subsequent heart failure. A dose-response association was observed between peak hs-TnT concentrations and incident heart failure.

PMID:
42669312
Bibliographic data and abstract were imported from PubMed on 31 Aug 2026.

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