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Association of high-sensitivity cardiac troponin T with mortality and cardiovascular events in a community-based prospective study in Beijing

OBJECTIVE: The prognostic value of cardiac troponins in apparently healthy populations is not well established. The aim of this study was to investigate the prognostic properties of high-sensitivity cardiac troponin T (hs-cTnT) for long-term adverse outcomes. SETTING: A community-dwelling prospectiv...

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Autores principales: Xiao, Wenkai, Cao, Ruihua, Liu, Yuan, Wang, Fan, Bai, Yongyi, Wu, Hongmei, Ye, Ping
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5541394/
https://www.ncbi.nlm.nih.gov/pubmed/28652289
http://dx.doi.org/10.1136/bmjopen-2016-013431
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author Xiao, Wenkai
Cao, Ruihua
Liu, Yuan
Wang, Fan
Bai, Yongyi
Wu, Hongmei
Ye, Ping
author_facet Xiao, Wenkai
Cao, Ruihua
Liu, Yuan
Wang, Fan
Bai, Yongyi
Wu, Hongmei
Ye, Ping
author_sort Xiao, Wenkai
collection PubMed
description OBJECTIVE: The prognostic value of cardiac troponins in apparently healthy populations is not well established. The aim of this study was to investigate the prognostic properties of high-sensitivity cardiac troponin T (hs-cTnT) for long-term adverse outcomes. SETTING: A community-dwelling prospective survey of residents from two communities in Beijing. PARTICIPANTS: From September 2007 to January 2009, 1680 participants were initially enrolled. Of these, 1499 (870 females, mean age: 61.4 years) participants completed the survey and were followed up for a median of 4.8 years (IQR: 4.5–5.2). OUTCOME MEASURES: The primary outcome was the occurrence of all-cause mortality and major cardiovascular events. RESULTS: Overall, 820 individuals (54.7%) had detectable hs-cTnT levels. During the follow-up, 52 participants (3.5%) died, 154 (10.3%) had major cardiovascular events and 99 (6.6%) experienced new-onset coronary events. Compared with those with undetectable hs-cTnT levels, participants with hs-cTnT levels in the highest category (≥14 ng/L) had a significantly increased risk for all-cause mortality (adjusted HR (aHR): 2.07, 95% CI 1.05 to 3.01), major cardiovascular events (aHR: 3.27, 95% CI 1.88 to 5.70) and coronary events (aHR: 4.50, 95% CI 2.26 to 9.02) in covariate-adjusted analyses. No differences in stroke incidence were found (aHR: 1.27, 95% CI 0.69 to 2.62). Also, significant associations were presented when hs-cTnT levels were modelled as a continuous variable and when analysing changes in hs-cTnT levels over time with adverse outcomes. The addition of troponin T levels to clinical variables led to significant increases in risk prediction with a marked improvement in the C-statistics (p=0.003 or lower). CONCLUSIONS: In this cohort of individuals from a community-based population, cTnT levels measured with a highly sensitive assay were associated with increases in the subsequent risk for all-cause mortality and major cardiovascular events. These results might support screening for at-risk individuals.
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spelling pubmed-55413942017-08-07 Association of high-sensitivity cardiac troponin T with mortality and cardiovascular events in a community-based prospective study in Beijing Xiao, Wenkai Cao, Ruihua Liu, Yuan Wang, Fan Bai, Yongyi Wu, Hongmei Ye, Ping BMJ Open Cardiovascular Medicine OBJECTIVE: The prognostic value of cardiac troponins in apparently healthy populations is not well established. The aim of this study was to investigate the prognostic properties of high-sensitivity cardiac troponin T (hs-cTnT) for long-term adverse outcomes. SETTING: A community-dwelling prospective survey of residents from two communities in Beijing. PARTICIPANTS: From September 2007 to January 2009, 1680 participants were initially enrolled. Of these, 1499 (870 females, mean age: 61.4 years) participants completed the survey and were followed up for a median of 4.8 years (IQR: 4.5–5.2). OUTCOME MEASURES: The primary outcome was the occurrence of all-cause mortality and major cardiovascular events. RESULTS: Overall, 820 individuals (54.7%) had detectable hs-cTnT levels. During the follow-up, 52 participants (3.5%) died, 154 (10.3%) had major cardiovascular events and 99 (6.6%) experienced new-onset coronary events. Compared with those with undetectable hs-cTnT levels, participants with hs-cTnT levels in the highest category (≥14 ng/L) had a significantly increased risk for all-cause mortality (adjusted HR (aHR): 2.07, 95% CI 1.05 to 3.01), major cardiovascular events (aHR: 3.27, 95% CI 1.88 to 5.70) and coronary events (aHR: 4.50, 95% CI 2.26 to 9.02) in covariate-adjusted analyses. No differences in stroke incidence were found (aHR: 1.27, 95% CI 0.69 to 2.62). Also, significant associations were presented when hs-cTnT levels were modelled as a continuous variable and when analysing changes in hs-cTnT levels over time with adverse outcomes. The addition of troponin T levels to clinical variables led to significant increases in risk prediction with a marked improvement in the C-statistics (p=0.003 or lower). CONCLUSIONS: In this cohort of individuals from a community-based population, cTnT levels measured with a highly sensitive assay were associated with increases in the subsequent risk for all-cause mortality and major cardiovascular events. These results might support screening for at-risk individuals. BMJ Publishing Group 2017-06-26 /pmc/articles/PMC5541394/ /pubmed/28652289 http://dx.doi.org/10.1136/bmjopen-2016-013431 Text en © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Cardiovascular Medicine
Xiao, Wenkai
Cao, Ruihua
Liu, Yuan
Wang, Fan
Bai, Yongyi
Wu, Hongmei
Ye, Ping
Association of high-sensitivity cardiac troponin T with mortality and cardiovascular events in a community-based prospective study in Beijing
title Association of high-sensitivity cardiac troponin T with mortality and cardiovascular events in a community-based prospective study in Beijing
title_full Association of high-sensitivity cardiac troponin T with mortality and cardiovascular events in a community-based prospective study in Beijing
title_fullStr Association of high-sensitivity cardiac troponin T with mortality and cardiovascular events in a community-based prospective study in Beijing
title_full_unstemmed Association of high-sensitivity cardiac troponin T with mortality and cardiovascular events in a community-based prospective study in Beijing
title_short Association of high-sensitivity cardiac troponin T with mortality and cardiovascular events in a community-based prospective study in Beijing
title_sort association of high-sensitivity cardiac troponin t with mortality and cardiovascular events in a community-based prospective study in beijing
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5541394/
https://www.ncbi.nlm.nih.gov/pubmed/28652289
http://dx.doi.org/10.1136/bmjopen-2016-013431
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