Heart failure & cardiomyopathies
High-Sensitivity Cardiac Troponin I for Risk Stratification in Wild-Type Transthyretin Amyloid Cardiomyopathy
Authors' conclusion
In patients with wild-type transthyretin amyloid cardiomyopathy, hs-cTnI is a strong and independent predictor of mortality. A threshold of hs-cTnI of 80 ng/L for these 3 assays provides effective risk stratification alone and in a staging system with NP.
Study context
- Population
- Stable wild-type transthyretin amyloid cardiomyopathy patients
- Participants
- 136 / 98 / 345
- Exposure
- Prognostic performance of hs-cTnI measured with different assays for all-cause mortality
- Abbott cohortn = 136
- Beckman cohortn = 98
- Siemens cohortn = 345
- Outcome
- All-cause mortality per natural log-transformed hs-cTnI
Methodological detailstesting cohorts and validation cohort
- Testing cohorts and validation cohort
Main finding
As reported in the abstract
Age- and sex-adjusted hazard ratio, per natural log-transformed hs-cTnI (95% CI)P value
Abbott cohort
1.62(1.11–2.35)
P = 0.012Beckman cohort
2.47(1.48–4.14)
P < 0.001Per natural log-transformed hs-cTnI, as printed
Observational data: associations, not effects.
Further findings
| Outcome | Siemens cohort |
|---|---|
| Staging system applied to Siemens validation cohort | deaths 34% |
| Median follow-up | 32 [24-42] months |
Best hs-cTnI threshold for 18-month mortality (combined Abbott/Beckman cohorts, n=234)
ng/L
- Best threshold
- 81
- Rounded threshold for clinical use
- 80
2-variable staging system (hs-cTnI >80 ng/L and NT-proBNP >3000 ng/L or BNP >250 ng/L)
- Identified 3 groups with progressively worse prognosis
Staging system applied to Siemens validation cohort
- The significant differences between the groups were maintained
Original publication
High-Sensitivity Cardiac Troponin I for Risk Stratification in Wild-Type Transthyretin Amyloid Cardiomyopathy. Circ Heart Fail. Published 15 May 2025. doi:10.
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