Association of Longitudinal High‐Sensitivity Cardiac Troponin T With Clinical Outcomes in Adult Heart‐Transplant Recipients

Background Cardiac troponin T is associated with mortality in heart transplantation recipients, but the association between its longitudinal measurements and clinical outcomes has not been evaluated. This study aimed to determine whether 3 parameterizations of serial hs‐ cTnT (high‐sensitivity cardiac troponin T)—instantaneous concentration, temporal trend, and cumulative exposure—are associated with clinical outcomes in this population. Methods In a retrospective analysis, 222 heart transplantation recipients (median age 50 years, 86% men) who survived >30 days post transplant were included. Joint models were used to analyze the association between longitudinal hs‐ cTnT and the primary outcome of all‐cause mortality and the secondary outcome of major adverse cardiac events. Results Over a median follow‐up of 2.3 years, 32 deaths and 41 major adverse cardiac events occurred. Both instantaneous hs‐ cTnT concentration (hazard ratio [ HR], 1.85 [95% CI, 1.48–2.31]; P