Study: New Test May Predict Heart Failure in Symptomless, Older Adults

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Patients over 65 account for most new cases of heart failure in the U.S., but, based on traditional risk factors, it’s hard for doctors to identify who is at highest risk for hospitalization or death. Now, researchers report that a highly sensitive new blood test for troponin T, a marker of cell death that has previously been associated with heart failure, can help predict risk, even in healthy, spry senior citizens who don’t show any heart symptoms.

The new study involved 4,000 men and women over age 65 who had never experienced symptoms of heart failure, had not been hospitalized and had no history of acute illness. The participants, who were part of the 21-year-old Cardiovascular Health Study (CHS), provided blood samples every 2 to 3 years for a total of 12 years, ending in 2008. Researchers tested the blood for troponin T using the new screen, which is about 10 times more sensitive than the one that is currently used in patients who are considered at risk for heart failure. That test is typically used to provide supplemental information to other clinical risk factors. (More on Can Heart Attacks Be Predicted With a Blood Test?)

The study results suggested that adults with detectable levels of troponin T were more likely to develop heart failure or die from a heart-related cause than patients with undetectable levels; increases in troponin T levels of more than 50% from baseline were also associated with increased risk of heart failure and death. Conversely, when levels of troponin T dropped, so did heart risk. “These fluctuations suggest that even in people without clinical symptoms of heart disease, we may be able to intervene with lifestyle modifications to lower their risks,” said lead author Dr. Christopher deFilippi.

“This study may have important clinical implications, since it suggests that physicians need to consider that test results are more dynamic over time and that risk factors are also likely to change over time,” said Dr. E. Albert Reece, vice president for medical affairs at the University of Maryland and dean of the University of Maryland School of Medicine where the study was conducted. (More on Study: Putting More People on Cholesterol-Lowering Drugs Could Save Money)

The study was presented at the Scientific Sessions of the American Heart Association and published Nov. 15 by the Journal of the American Medical Association (JAMA).

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