A small rise in heart attack protein linked to increased risk of early death

An analysis of patients’ heart data has shown that even a small increase in a protein linked to heart attacks is linked to an increased risk of death.

In a new study by the National Institute of Health Research Health Informatics Collaborative (NIHR-HIC) led by Imperial College Healthcare NHS Trust and Imperial College London have discovered that an increase in troponin level is associated with increased risk of early death.

They additionally indicated that regardless of age, the higher the amount of troponin in the blood, the higher the risk of death in patients with a heart attack. The outcomes propose that even a little ascent in troponin in all age groups is clinically significant and can show underlying health problems.

Troponins are a group of proteins found in skeletal and heart (cardiac) muscle fibers that regulate muscular contraction. Troponin tests measure the level of cardiac-specific troponin in the blood to help detect heart injury.

Intriguingly, the findings suggest that very high levels of troponin in the blood in patients with a heart attack was associated with a lower risk of dying. The possible reason behind this is that patients with exceptionally high troponin levels are bound to have a type of heart attack which can be treated by an operation to improve blood flow to the heart and consequently diminish the risk of dying.

Amit Kaura, a lead author of the research and NIHR Clinical Research Fellow at Imperial College London, said: “There have been many advances in treating heart disease yet it remains the leading cause of death in the UK and around the world. This is the first study to address the implications of raised troponin in a real-world sample of patients across a wide range of ages. Doctors will be able to use this information to help identify the risk of early death in patients who have a troponin level measured; this could lead to interventions at a much earlier stage in a wider group of patients than are currently treated.”

In young patients (18-29 years), those whose blood showed a raised troponin had a 10-fold higher risk of death than those whose blood did not. This increased risk fell with age, reaching 1.5 times the risk in patients over the age of 90. Nevertheless, even in very elderly patients, raised troponin in the blood signifies a higher risk of dying. Over the age of 80, almost half of patients with an increased troponin level dies within three years.

For the study, scientists analysed the anonymised cardiovascular data of more than 250,000 patients who had troponin tests at National Institute for Health Research Health Informatics Collaborative sites including: Imperial College Healthcare NHS Trust, University College London Hospitals NHS Foundation Trust, Oxford University Hospitals NHS Foundation Trust, King’s College Hospital NHS Foundation Trust and Guy’s and St Thomas’ NHS Foundation Trust from 2010-2017. The team grouped the patients by age and compared their troponin results with their outcomes over three years.

In further studies, scientists are planning to see if patients with a raised troponin, without a heart attack, may benefit from cardiac treatments, including cholesterol-lowering medication, such as a statin.

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