Troponin elevation in heart failure: Prevalence, mechanisms, and clinical implications

Robb D. Kociol, Peter S. Pang, Mihai Gheorghiade, Gregg C. Fonarow, Christopher M. O'Connor, G. Michael Felker

Research output: Contribution to journalReview articlepeer-review

368 Scopus citations


Circulating biomarkers have become increasingly important in diagnosing and risk stratifying patients with heart failure (HF). While the natriuretic peptides have received much focus, there is increasing interest in the role of circulating cardiac troponin (cTn) in detecting myocardial injury (often subclinical) in those with HF. Accumulating evidence suggests that patients with chronic and acute HF may have measurable levels of circulating cTn, whose detection and magnitude may have prognostic implications. Furthermore, as new, more sensitive cTn assays are being developed, larger numbers of HF patients are found to have detectable cTn with a persistent relationship between magnitude and outcome. This knowledge improves our ability to understand the mechanism of worsening HF, improve risk stratification, and detect potential injury related to new therapeutics in HF. As investigators begin to understand the relationship of detectable cTn to HF outcomes, as well as temporal changes in its magnitude, and its relationship to other circulating biomarkers, more insight may be gained into the progressive nature of cardiac dysfunction and the transition from chronic compensated to acute decompensated HF. Ultimately, this information might allow physicians to guide therapy, choose appropriate therapeutics, and improve HF outcomes.

Original languageEnglish (US)
Pages (from-to)1071-1078
Number of pages8
JournalJournal of the American College of Cardiology
Issue number14
StatePublished - Sep 28 2010


  • biomarkers
  • heart failure
  • outcomes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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