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What Is the Clinical Utility of Cardiac Troponins in Heart Failure? Are They Modifiable Beyond Their Prognostic Value?

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Abstract

Purpose of Review

To review the role of cardiac troponin (cTn) for prognosis in acute and chronic heart failure, and for predicting heart failure; and to explore the association between troponin and response to heart failure therapies, with an eye toward a possible role for troponin in a personalized approach to heart failure management, beyond prognosis.

Recent Findings

A number of therapies, including the neprilysin inhibitor sacubitril/valsartan and sodium-glucose cotransporter-2 inhibitors, have recently been shown to improve outcomes in heart failure patients. Most studies suggest that these agents improve outcomes regardless of baseline cTn concentration, but have greater absolute benefit among patients with highest cTn and baseline risk.

Summary

Troponin is prognostic across the heart failure spectrum, but whether it can significantly help with heart failure prevention and with tailoring and guiding heart failure treatments and interventions remains unknown.

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Papers of particular interest, published recently, have been highlighted as: • Of importance

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Authors and Affiliations

  1. Division of Cardiovascular Medicine, Sulpizio Cardiovascular Center, UC San Diego, 9452 Medical Center Drive, La Jolla, CA, 92037-7411, USA

    David Agdashian & Lori B. Daniels

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  1. David Agdashian
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  2. Lori B. Daniels
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Correspondence to Lori B. Daniels.

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Conflict of Interest

LBD has received consulting fees from Quidel, Roche Diagnostics, and Siemens; and has served on Clinical Endpoints Adjudication Committees for Abbott and Applied Therapeutics. DA declares that he has no conflict of interest.

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Agdashian, D., Daniels, L.B. What Is the Clinical Utility of Cardiac Troponins in Heart Failure? Are They Modifiable Beyond Their Prognostic Value?. Curr Heart Fail Rep 20, 33–43 (2023). https://doi.org/10.1007/s11897-023-00588-z

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  • DOI: https://doi.org/10.1007/s11897-023-00588-z

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