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Cardiac Troponin I and Incident Stroke in European Cohorts: Insights From the BiomarCaRE Project

BACKGROUND AND PURPOSE: Stroke is a common cause of death and a leading cause of disability and morbidity. Stroke risk assessment remains a challenge, but circulating biomarkers may improve risk prediction. Controversial evidence is available on the predictive ability of troponin concentrations and...

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Autores principales: Camen, Stephan, Palosaari, Tarja, Reinikainen, Jaakko, Sprünker, Ngoc Anh, Niiranen, Teemu, Gianfagna, Francesco, Vishram-Nielsen, Julie K.K., Costanzo, Simona, Söderberg, Stefan, Palmieri, Luigi, Ferrario, Marco, Peters, Annette, Vartiainen, Erkki, Donati, Maria Benedetta, Donfrancesco, Chiara, Borchini, Rossana, Börschel, Christin Susanna, Giampaoli, Simona, Di Castelnuovo, Augusto, Magnussen, Christina, Kee, Frank, Koenig, Wolfgang, Blankenberg, Stefan, de Gaetano, Giovanni, Tunstall-Pedoe, Hugh, Rospleszcz, Susanne, Jørgensen, Torben, Zeller, Tanja, Kuulasmaa, Kari, Linneberg, Allan, Salomaa, Veikko, Iacoviello, Licia, Schnabel, Renate B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7447179/
https://www.ncbi.nlm.nih.gov/pubmed/32811388
http://dx.doi.org/10.1161/STROKEAHA.120.029452
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author Camen, Stephan
Palosaari, Tarja
Reinikainen, Jaakko
Sprünker, Ngoc Anh
Niiranen, Teemu
Gianfagna, Francesco
Vishram-Nielsen, Julie K.K.
Costanzo, Simona
Söderberg, Stefan
Palmieri, Luigi
Ferrario, Marco
Peters, Annette
Vartiainen, Erkki
Donati, Maria Benedetta
Donfrancesco, Chiara
Borchini, Rossana
Börschel, Christin Susanna
Giampaoli, Simona
Di Castelnuovo, Augusto
Magnussen, Christina
Kee, Frank
Koenig, Wolfgang
Blankenberg, Stefan
de Gaetano, Giovanni
Tunstall-Pedoe, Hugh
Rospleszcz, Susanne
Jørgensen, Torben
Zeller, Tanja
Kuulasmaa, Kari
Linneberg, Allan
Salomaa, Veikko
Iacoviello, Licia
Schnabel, Renate B.
author_facet Camen, Stephan
Palosaari, Tarja
Reinikainen, Jaakko
Sprünker, Ngoc Anh
Niiranen, Teemu
Gianfagna, Francesco
Vishram-Nielsen, Julie K.K.
Costanzo, Simona
Söderberg, Stefan
Palmieri, Luigi
Ferrario, Marco
Peters, Annette
Vartiainen, Erkki
Donati, Maria Benedetta
Donfrancesco, Chiara
Borchini, Rossana
Börschel, Christin Susanna
Giampaoli, Simona
Di Castelnuovo, Augusto
Magnussen, Christina
Kee, Frank
Koenig, Wolfgang
Blankenberg, Stefan
de Gaetano, Giovanni
Tunstall-Pedoe, Hugh
Rospleszcz, Susanne
Jørgensen, Torben
Zeller, Tanja
Kuulasmaa, Kari
Linneberg, Allan
Salomaa, Veikko
Iacoviello, Licia
Schnabel, Renate B.
author_sort Camen, Stephan
collection PubMed
description BACKGROUND AND PURPOSE: Stroke is a common cause of death and a leading cause of disability and morbidity. Stroke risk assessment remains a challenge, but circulating biomarkers may improve risk prediction. Controversial evidence is available on the predictive ability of troponin concentrations and the risk of stroke in the community. Furthermore, reports on the predictive value of troponin concentrations for different stroke subtypes are scarce. METHODS: High-sensitivity cardiac troponin I (hsTnI) concentrations were assessed in 82 881 individuals (median age, 50.7 years; 49.7% men) free of stroke or myocardial infarction at baseline from 9 prospective European community cohorts. We used Cox proportional hazards regression to determine relative risks, followed by measures of discrimination and reclassification using 10-fold cross-validation to control for overoptimism. Follow-up was based upon linkage with national hospitalization registries and causes of death registries. RESULTS: Over a median follow-up of 12.7 years, 3033 individuals were diagnosed with incident nonfatal or fatal stroke (n=1654 ischemic strokes, n=612 hemorrhagic strokes, and n=767 indeterminate strokes). In multivariable regression models, hsTnI concentrations were associated with overall stroke (hazard ratio per 1-SD increase, 1.15 [95% CI, 1.10–1.21]), ischemic stroke (hazard ratio, 1.14 [95% CI, 1.09–1.21]), and hemorrhagic stroke (hazard ratio, 1.10 [95% CI, 1.01–1.20]). Adding hsTnI concentrations to classical cardiovascular risk factors (C indices, 0.809, 0.840, and 0.736 for overall, ischemic, and hemorrhagic stroke, respectively) increased the C index significantly but modestly. In individuals with an intermediate 10-year risk (5%–20%), the net reclassification improvement for overall stroke was 0.038 (P=0.021). CONCLUSIONS: Elevated hsTnI concentrations are associated with an increased risk of incident stroke in the community, irrespective of stroke subtype. Adding hsTnI concentrations to classical risk factors only modestly improved estimation of 10-year risk of stroke in the overall cohort but might be of some value in individuals at an intermediate risk.
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spelling pubmed-74471792020-09-11 Cardiac Troponin I and Incident Stroke in European Cohorts: Insights From the BiomarCaRE Project Camen, Stephan Palosaari, Tarja Reinikainen, Jaakko Sprünker, Ngoc Anh Niiranen, Teemu Gianfagna, Francesco Vishram-Nielsen, Julie K.K. Costanzo, Simona Söderberg, Stefan Palmieri, Luigi Ferrario, Marco Peters, Annette Vartiainen, Erkki Donati, Maria Benedetta Donfrancesco, Chiara Borchini, Rossana Börschel, Christin Susanna Giampaoli, Simona Di Castelnuovo, Augusto Magnussen, Christina Kee, Frank Koenig, Wolfgang Blankenberg, Stefan de Gaetano, Giovanni Tunstall-Pedoe, Hugh Rospleszcz, Susanne Jørgensen, Torben Zeller, Tanja Kuulasmaa, Kari Linneberg, Allan Salomaa, Veikko Iacoviello, Licia Schnabel, Renate B. Stroke Original Contributions BACKGROUND AND PURPOSE: Stroke is a common cause of death and a leading cause of disability and morbidity. Stroke risk assessment remains a challenge, but circulating biomarkers may improve risk prediction. Controversial evidence is available on the predictive ability of troponin concentrations and the risk of stroke in the community. Furthermore, reports on the predictive value of troponin concentrations for different stroke subtypes are scarce. METHODS: High-sensitivity cardiac troponin I (hsTnI) concentrations were assessed in 82 881 individuals (median age, 50.7 years; 49.7% men) free of stroke or myocardial infarction at baseline from 9 prospective European community cohorts. We used Cox proportional hazards regression to determine relative risks, followed by measures of discrimination and reclassification using 10-fold cross-validation to control for overoptimism. Follow-up was based upon linkage with national hospitalization registries and causes of death registries. RESULTS: Over a median follow-up of 12.7 years, 3033 individuals were diagnosed with incident nonfatal or fatal stroke (n=1654 ischemic strokes, n=612 hemorrhagic strokes, and n=767 indeterminate strokes). In multivariable regression models, hsTnI concentrations were associated with overall stroke (hazard ratio per 1-SD increase, 1.15 [95% CI, 1.10–1.21]), ischemic stroke (hazard ratio, 1.14 [95% CI, 1.09–1.21]), and hemorrhagic stroke (hazard ratio, 1.10 [95% CI, 1.01–1.20]). Adding hsTnI concentrations to classical cardiovascular risk factors (C indices, 0.809, 0.840, and 0.736 for overall, ischemic, and hemorrhagic stroke, respectively) increased the C index significantly but modestly. In individuals with an intermediate 10-year risk (5%–20%), the net reclassification improvement for overall stroke was 0.038 (P=0.021). CONCLUSIONS: Elevated hsTnI concentrations are associated with an increased risk of incident stroke in the community, irrespective of stroke subtype. Adding hsTnI concentrations to classical risk factors only modestly improved estimation of 10-year risk of stroke in the overall cohort but might be of some value in individuals at an intermediate risk. Lippincott Williams & Wilkins 2020-09 2020-08-19 /pmc/articles/PMC7447179/ /pubmed/32811388 http://dx.doi.org/10.1161/STROKEAHA.120.029452 Text en © 2020 The Authors. Stroke is published on behalf of the American Heart Association, Inc., by Wolters Kluwer Health, Inc. This is an open access article under the terms of the Creative Commons Attribution Non-Commercial-NoDerivs (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use, distribution, and reproduction in any medium, provided that the original work is properly cited, the use is noncommercial, and no modifications or adaptations are made.
spellingShingle Original Contributions
Camen, Stephan
Palosaari, Tarja
Reinikainen, Jaakko
Sprünker, Ngoc Anh
Niiranen, Teemu
Gianfagna, Francesco
Vishram-Nielsen, Julie K.K.
Costanzo, Simona
Söderberg, Stefan
Palmieri, Luigi
Ferrario, Marco
Peters, Annette
Vartiainen, Erkki
Donati, Maria Benedetta
Donfrancesco, Chiara
Borchini, Rossana
Börschel, Christin Susanna
Giampaoli, Simona
Di Castelnuovo, Augusto
Magnussen, Christina
Kee, Frank
Koenig, Wolfgang
Blankenberg, Stefan
de Gaetano, Giovanni
Tunstall-Pedoe, Hugh
Rospleszcz, Susanne
Jørgensen, Torben
Zeller, Tanja
Kuulasmaa, Kari
Linneberg, Allan
Salomaa, Veikko
Iacoviello, Licia
Schnabel, Renate B.
Cardiac Troponin I and Incident Stroke in European Cohorts: Insights From the BiomarCaRE Project
title Cardiac Troponin I and Incident Stroke in European Cohorts: Insights From the BiomarCaRE Project
title_full Cardiac Troponin I and Incident Stroke in European Cohorts: Insights From the BiomarCaRE Project
title_fullStr Cardiac Troponin I and Incident Stroke in European Cohorts: Insights From the BiomarCaRE Project
title_full_unstemmed Cardiac Troponin I and Incident Stroke in European Cohorts: Insights From the BiomarCaRE Project
title_short Cardiac Troponin I and Incident Stroke in European Cohorts: Insights From the BiomarCaRE Project
title_sort cardiac troponin i and incident stroke in european cohorts: insights from the biomarcare project
topic Original Contributions
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7447179/
https://www.ncbi.nlm.nih.gov/pubmed/32811388
http://dx.doi.org/10.1161/STROKEAHA.120.029452
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