Decreased cTnT Levels Heart Failure Patients with Routinely Taking Standard Therapy


Extreme physical stressors like thirst increase the risk of non-communicable diseases, especially heart failure (HF). Cardiac patients should ensure adequate supplies of and adherence to medications. They must avoid crowds, perform certain rituals, and report to the nearest health center if symptoms indicate cardiac decompensation. However, in acute or chronic HF with reduced or preserved ejection fraction (EF), elevated cardiac troponin (cTn) levels carry prognostic value for adverse outcomes. A prospective observational study aimed to evaluate levels of cTnT before and after administration of standard therapy and treatment history in hospitalized HF patients. The samples were collected by consecutive sampling and obtained from 30 patients from May-July 2017. The results showed that the number of patients whose cTnT levels decreased by ten patients (30.68 vs. 12.96 pg/ml; p=0.005) increased by 12 patients (31.00 vs. 76.75 pg/ml; p=0.002) and persistent by eight patients (40.70 vs. 42.41 pg/ml; p=0.779). Changes in serum cTnT levels and the clinical condition of the patient, possible to consider the factors of the patient's clinical condition that affect cTnT levels. There was a decrease in levels of cTnT in patients who regularly took medication (10 patients, 29.74 vs. 17.97 pg/ml; p=0.037), while in patients who did not take medication regularly, there was an increase in levels of cTnT (20 patients, 35.35 vs. 60.51 pg/ml; p=0.025). Evaluation of patients' adherence to heart failure therapy has ruled out major risk factors, such as patients with uncontrolled heart disease, to reduce casualties during Hajj.

Author Biographies

Yen Yen Ari Indrawijaya, Universitas Airlangga

Master Program of Clinical Pharmacy, Airlangga University;
Department of Pharmacy, Faculty of Medicine and Health Sciences, UIN Maulana Malik Ibrahim Malang

Suharjono Suharjono, Universitas Airlangga

Department of Clinical Pharmacy, Faculty of Pharmacy, Airlangga University

Muhammad Aminuddin, Universitas Airlangga

Department of Cardiology and Vascular Medicine, Soetomo Teaching Hospital Surabaya, Faculty of Medicine, Airlangga University

Endang Retnowati, Universitas Airlangga

Department of Clinical Pathology Medicine, Soetomo Teaching Hospital Surabaya, Faculty of Medicine, Airlangga University

Gilang Mauladi Rahman, Universitas Airlangga

Department of Cardiology and Vascular Medicine, Soetomo Teaching Hospital Surabaya, Faculty of Medicine, Airlangga University


Babuin, L. and Jaffe, A. S. (2005) ‘Troponin: The biomarker of choice for the detection of cardiac injury’, CMAJ. Canadian Medical Association Journal, 173(10), pp. 1191–1202. doi: 10.1503/cmaj/051291.
Chamsi-Pasha, H., Ahmed, W. H. and Al-Shaibi, K. F. (2014) ‘The cardiac patient during Ramadan and Hajj’, Journal of the Saudi Heart Association, 26(4), pp. 212–215. doi: 10.1016/j.jsha.2014.04.002.
Cotter, G, Stough, WG, Felker, GM, et al 2005. ‘Acute heart failure: nomenclature, pathophysiology, and outcome measures’ in Managing acute decompensated heart failure, USA: Taylor & Francis, pp.19-36.
Felker, G. M. et al. (2015) ‘Serial high sensitivity cardiac troponin T measurement in acute heart failure: Insights from the RELAX-AHF study’, European Journal of Heart Failure, 17(12), pp. 1262–1270. doi: 10.1002/ejhf.341.
Ferreira, J. P. et al. (2014) ‘High-sensitivity troponin T: A biomarker for diuretic response in decompensated heart failure patients’, Cardiology Research and Practice, 2014. doi: 10.1155/2014/269604.
Friedrich, E. B. and Böhm, M. (2007) ‘Management of end stage heart failure’, Heart, 93(5), pp. 626–631. doi: 10.1136/hrt.2006.098814.
Gastelurrutia, P. et al. (2011) ‘Negative clinical outcomes associated with drug-related problems in heart failure (HF) outpatients: Impact of a pharmacist in a multidisciplinary HF clinic’, Journal of Cardiac Failure, 17(3), pp. 217–223. doi: 10.1016/j.cardfail.2010.10.009.
Grodin, JL, Tang, WHW 2013. ‘Prognostic role of cardiac troponin in heart failure’. American college of cardiology, pp.1-7.
Indrawijaya, Y. Y. A. et al. (2020) ‘Changes on Serum Troponin T Level before and after Taking Standard Therapy Medication in Heart Failure Patients’, Folia Medica Indonesiana, 56(1), p. 4. doi: 10.20473/fmi.v56i1.18444.
Kociol, R. D. et al. (2010) ‘Troponin elevation in heart failure: Prevalence, mechanisms, and clinical implications’, Journal of the American College of Cardiology, 56(14), pp. 1071–1078. doi: 10.1016/j.jacc.2010.06.016.
Krumholz, H. M. et al. (2009) ‘Patterns of hospital performance in acute myocardial infarction and heart failure 30-day mortality and readmission’, Circulation: Cardiovascular Quality and Outcomes, 2(5), pp. 407–413. doi: 10.1161/CIRCOUTCOMES.109.883256.
Latini, R. et al. (2007) ‘Prognostic value of very low plasma concentrations of troponin T in patients with stable chronic heart failure’, Circulation, 116(11), pp. 1242–1249. doi: 10.1161/CIRCULATIONAHA.106.655076.
Luttik, M. L. et al. (2005) ‘The importance and impact of social support on outcomes in patients with heart failure: An overview of the literature’, Journal of Cardiovascular Nursing, 20(3), pp. 162–169. doi: 10.1097/00005082-200505000-00007.
Maynard, S. J., Menown, I. B. A. and Adgey, A. A. J. (2000) ‘Troponin T or troponin I as cardiac markers in ischaemic heart disease’, Heart, 83(4), pp. 371–373. doi: 10.1136/heart.83.4.371.
Meredith, AJ., Dai, DLY., Chen,V., 2016. Circulating biomarker responses to medical management vs. mechanical circulatory support in severe inotrope-dependent acute heart failre.ESC Heart Failure: 3: pp-86-96.
Milfred-laforest, S. K. et al. (2013) ‘Clinical Pharmacy Services in Heart Failure : An Opinion Paper from the Heart Failure Society of America and’, Pharmacothery, 33(5), pp. 529–548.
Miller, W. L. et al. (2009) ‘Profiles of Serial Changes in Cardiac Troponin T Concentrations and Outcome in Ambulatory Patients With Chronic Heart Failure’, Journal of the American College of Cardiology, 54(18), pp. 1715–1721. doi: 10.1016/j.jacc.2009.07.025.
Parker, RB., Cavallari,, LH., 2011. Systolic heart failure. In Pharmacotherapy: a pathophysiologic approach, 8th edition, by JT. Dipiro, RL. Talbert, GC. Yee, GR. Matzke, BG. Wells, LM. Posey, New York: McGraw-Hill, pp-137-172.
Perhimpunan Dokter Spesialis Kardiovaskular Indonesia (PERKI) 2015. ‘Pedoman tatalaksana gagal jantung’, Indonesian Heart Association, vol.1, pp.1-47
Ramani, G. V., Uber, P. A. and Mehra, M. R. (2010) ‘Chronic heart failure: Contemporary diagnosis and management’, Mayo Clinic Proceedings, 85(2), pp. 180–195. doi: 10.4065/mcp.2009.0494.
Roger, V. L. (2013) ‘Epidemiology of heart failure’, Circulation Research, 113(6), pp. 646–659. doi: 10.1161/CIRCRESAHA.113.300268.
Takashio, S. et al. (2017) ‘Persistent increase in cardiac troponin T at hospital discharge predicts repeat hospitalization in patients with acute decompensated heart failure’, PLoS ONE, 12(4). doi: 10.1371/journal.pone.0173336.
Yancy, C. W. et al. (2013) ‘2013 ACCF/AHA guideline for the management of heart failure: A report of the American college of cardiology foundation/american heart association task force on practice guidelines’, Journal of the American College of Cardiology, 62(16). doi: 10.1016/j.jacc.2013.05.019.
How to Cite
INDRAWIJAYA, Yen Yen Ari et al. Decreased cTnT Levels Heart Failure Patients with Routinely Taking Standard Therapy. Proceeding Annual Symposium on Hajj and Umrah Medicine, [S.l.], v. 1, p. 48-56, dec. 2022. ISSN 2987-548X. Available at: <>. Date accessed: 21 may 2024. doi: