Records on follow-up cTnT levels, measured 2-3 years after baseline in 86% of the study participants, showed that among those with a detectable cTnT level at baseline, nearly two-thirds stayed at about the same level, 22% increased by more than 50%, and 14% decreased by more than 50%.
The high increasers had their subsequent heart failure and cardiovascular death rates rise by about 50% compared with people with more moderate changes. In contrast, among those whose levels fell by more than 50% during follow-up subsequent event rates dropped by about 25% compared with those with less change in their cTnT level. Concurrent with Dr. deFilippi's talk at the meeting the findings also appeared in an article published on-line (JAMA 2010; 304:doi:10.1001/jama.2010.1708).
The results of the study also identified a number of people with very high levels at baseline that then fell to an undetectable level at their second cTnT measurement. Few people showed this kind of change, but it occurred often enough for Dr. deFilippi to speculate that certain actions can effectively lower serum cTnT levels.
The source of the cTnT isn't clear. Dr. deFilippi said that he believes it's caused by a chronic process, although the specifics remain unknown. “It's unlikely an ischemic cause,” he said. “The issue is, once you see [a high level,] can you intervene? Right now, that's an open question.
Over 12 years, the rates of heart failure and cardiac death tracked along with baseline cTnT levels.
Source DR. DeFILIPPI