Troponin-T Levels: New A-fib Risk Factor?

A study published last month found that serial measures of high sensitivity cardiac troponin-T (hs-cTnT) levels may be used to predict incident atrial fibrillation (AF) independent of traditional risk factors. The study suggests that circulating troponin levels caused by either myocyte damage or protein turnover predispose older adults to AF and that it is a important part of the cardiac remodeling process. Higher baseline levels of Troponin-T were associated with a higher likelihood of developing incident AF. There are currently no interventions available for elevated troponin-T levels as a risk factor for developing AF but this association is important to advance knowledge regarding the mechanisms that lead to AF.

I believe that this is an interesting study because usually sometimes people may not even recognize symptoms of A-fib and the diagnosis may be delayed if people to not seek treatment, which could potentially lead to poorer outcomes. Although there are currently no interventions for elevated troponin-T levels as predictors of A-fib, the idea of an additional risk factor for A-fib could at the very least make providers more aware of the problem so that they could monitor patients closely and educate them of the signs and symptoms of A-fib if it does occur. Hopefully in the future we will be able to use this biomarker to “catch” A-fib and implement interventions before it even happens.

 

Hussein A, Bartz T, Gottdiener J, et al. Serial measures of cardiac troponin-T levels by a highly sensitive assay and incident atrial fibrillation in a prospective cohort of ambulatory older adults. Heart Rhythm 2015; DOI:10.1016/j.hrthm.2015.01.020