Serial Cardiac Troponin Measurements: A Prediction Tool for Heart Failure Risk in Black Patients?

Abstract

Black adults are disproportionately affected by heart failure (HF), and incident HF rates are increasing in Black adults, who also have higher risks of hospitalization and age-adjusted mortality due to HF than White adults. These disparities in HF have, in part, been attributed to a higher prevalence of cardiovascular (CV) risk factors, inadequate treatment of HF and underuse of HF guideline-directed medical therapy. Understanding novel factors that may contribute to the heterogeneity of HF in Black individuals remains an unmet need. Tools that can be used for early detection of incident HF are potentially impactful because early detection can open the window for preventive or therapeutic strategies that reduce the risk of future clinical HF. Biomarkers, such as natriuretic peptides and high-sensitivity troponins, may represent emerging tools to better predict risk of incident HF in vulnerable populations at risk of cardiovascular disease (CVD) due to the reduced detection threshold of current assays. High-sensitivity cardiac troponins (hs-cTns) are specific and sensitive biomarkers of myocardial injury, whereas elevated natriuretic peptide levels in response to increased wall stretch due to volume or pressure overload are associated with increased risk of incident HF in adults.