New and far more sensitive assays made it possible for a team of investigators in San Diego to propose a new biomarker that could be used to better evaluate a heart failure patient's chances of death or readmission.
Up to now, clinicians have relied on an unreliable test on a biomarker known as pro-B-type natriuretic peptide--BNP--to test heart failure patients' risk of a relapse. Heart failure is one of the most common conditions that lead to hospitalization, and the risk of a setback presents an enormously costly conundrum for payers. So a team of investigators at the San Diego Veteran Affairs Medical Center set out to see if troponin offered a better way to gauge the risks faced by 144 patients with acute heart failure.
Using nanotechnology, they were able to use a far more sensitive assay to accurately detect levels of troponin at tiny nanogram levels in virtually all of the patients. And they found that even small elevations in troponin during hospitalization for heart failure are associated with increased 90-day mortality and readmission. Serial increases in troponin concentrations during hospitalization are associated with higher mortality than stable or decreasing levels.
"The fact that 99% of our samples had measurable levels highlights the feasibility of measuring troponin in virtually all heart failure patients," said UC San Diego's Dr. Yang Xue. "This was simply not possible with earlier assays. But it did allow us to detect a trend of increasing troponin levels during the 90-day study period which was significantly associated with an increased risk of mortality which was not evident in patients with stable or decreasing levels. These findings may help identify a previously unidentified subgroup of high-risk patients who need closer monitoring in hospital and post-discharge."
- here's the release