Move Over, CRP - Troponin is the New Cardiovascular Disease Marker

C-reactive protein (CRP) has been an accepted telltale marker of inflammatory change, which means it’s raised if there is inflammation in the body, including the cardiovascular system.  Thus it’s been regarded (somewhat half-heartedly) as a good marker of cardiovascular disease.  Cardiac troponin-T, on the other hand, is associated with damaged cardiac muscle, and is a good marker for heart attack, or myocardial infarction.  Now two studies have been published that show that raised cardiac troponin-T, or troponin for short, can be a risk factor for heart failure and cardiovascular mortality, with or without of heart attack.

The first study, published in the Journal of the American Medical Association, was done at the University of Maryland.  Over 4,200 adults over 65 without heart failure had their cardiac troponin-T measured at baseline, and again after 2 to 3 years.  New-onset cases of heart failure and cardiac deaths were recorded, and related to the troponin levels.  A clear association was reported between cardiac troponin-T levels and subsequent heart failure and/or cardiac mortality.

The second study, reported from the University of Texas, was also published in the Journal of the American Medical Association.  In this case, a relatively young population (30- to 65-year-olds) was followed for an average of 6.4years.  Over 3,500 people from Dallas were enrolled and classified into groups based on their cardiac troponin-T levels.  Mortality together with magnetic resonance imaging (MRI) of cardiac structure and function, were measured during the study.  Higher cardiac troponin-T levels were associated with increased left ventricular size, with the highest levels (above 0.014 ng/mL) linked with dysfunction of the left ventricle during systole,  chronic kidney disease, and 28.4% mortality.  The conclusion of the investigators is that raised cardiac troponin-T is “associated with structural heart disease and subsequent risk for all-cause mortality”.           

It’s tough to keep up with the various tests for heart potential problems.  Maybe it’s enough to remember that a raised CRP is indicative of inflammatory changes in cardiac tissues and vessels, while a raised troponin-T suggests microscopic damage to cardiac muscle and possible structural damage to the heart.  Of course, either finding means you should probably eat right, lose weight, exercise more, and so one –  just ask your doctor.