Information de reference pour ce titreAccession Number: | 00003017-201906040-00008.
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Author: | Jia, Xiaoming MD; Sun, Wensheng MPH, MS; Hoogeveen, Ron C. PhD; Nambi, Vijay MD, PhD; Matsushita, Kunihiro MD, PhD; Folsom, Aaron R. MD, MPH; Heiss, Gerardo MD, MSc, PhD; Couper, David J. PhD; Solomon, Scott D. MD; Boerwinkle, Eric PhD; Shah, Amil MD; Selvin, Elizabeth PhD, MPH; de Lemos, James A. MD; Ballantyne, Christie M. MD
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Institution: | Baylor College of Medicine, Houston, TX (X.J., W.S., R.C.H., V.N., C.M.B.). Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX (V.N.). Johns Hopkins University, Baltimore, MD (K.M., E.S.). University of Minnesota, Minneapolis (A.R.F.). University of North Carolina at Chapel Hill (G.H., D.J.C.). Brigham and Women's Hospital, Boston, MA (S.D.S., A.S.). University of Texas Health Science Center at Houston (E.B.). University of Texas-Southwestern Medical Center, Dallas (J.A.d.L.).
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Title: | |
Source: | Circulation. 139(23):2642-2653, June 4, 2019.
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Abstract: | Background: We assessed whether plasma troponin I measured by a high-sensitivity assay (hs-TnI) is associated with incident cardiovascular disease (CVD) and mortality in a community-based sample without prior CVD.
Methods: ARIC study (Atherosclerosis Risk in Communities) participants aged 54 to 74 years without baseline CVD were included in this study (n=8121). Cox proportional hazards models were constructed to determine associations between hs-TnI and incident coronary heart disease (CHD; myocardial infarction and fatal CHD), ischemic stroke, atherosclerotic CVD (CHD and stroke), heart failure hospitalization, global CVD (atherosclerotic CVD and heart failure), and all-cause mortality. The comparative association of hs-TnI and high-sensitivity troponin T with incident CVD events was also evaluated. Risk prediction models were constructed to assess prediction improvement when hs-TnI was added to traditional risk factors used in the Pooled Cohort Equation.
Results: The median follow-up period was [almost equal to]15 years. Detectable hs-TnI levels were observed in 85% of the study population. In adjusted models, in comparison to low hs-TnI (lowest quintile, hs-TnI <=1.3 ng/L), elevated hs-TnI (highest quintile, hs-TnI >=3.8 ng/L) was associated with greater incident CHD (hazard ratio [HR], 2.20; 95% CI, 1.64-2.95), ischemic stroke (HR, 2.99; 95% CI, 2.01-4.46), atherosclerotic CVD (HR, 2.36; 95% CI, 1.86-3.00), heart failure hospitalization (HR, 4.20; 95% CI, 3.28-5.37), global CVD (HR, 3.01; 95% CI, 2.50-3.63), and all-cause mortality (HR, 1.83; 95% CI, 1.56-2.14). hs-TnI was observed to have a stronger association with incident global CVD events in white than in black individuals and a stronger association with incident CHD in women than in men. hs-TnI and high-sensitivity troponin T were only modestly correlated (r=0.47) and were complementary in prediction of incident CVD events, with elevation of both troponins conferring the highest risk in comparison with elevation in either one alone. The addition of hs-TnI to the Pooled Cohort Equation model improved risk prediction for atherosclerotic CVD, heart failure, and global CVD.
Conclusions: Elevated hs-TnI is strongly associated with increased global CVD incidence in the general population independent of traditional risk factors. hs-TnI and high-sensitivity troponin T provide complementary rather than redundant information.
(C) 2019 by the American College of Cardiology Foundation and the American Heart Association, Inc.
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Author Keywords: | biomarkers; cardiovascular diseases; troponin I.
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Language: | English.
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Document Type: | Original Research Articles.
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Journal Subset: | Clinical Medicine.
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ISSN: | 0009-7322
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NLM Journal Code: | daw, 0147763
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DOI Number: | https://dx.doi.org/10.1161/CIRCU...- ouverture dans une nouvelle fenêtre
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