scholarly journals High-Sensitivity Cardiac Troponin T Is a Risk Factor for Major Adverse Cardiovascular Events and All-Cause Mortality: A 9.5-Year Follow-Up Study

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Xiaona Wang ◽  
Peiqi Wang ◽  
Ruihua Cao ◽  
Xu Yang ◽  
Wenkai Xiao ◽  
...  

Background. The relationship between high-sensitivity cardiac troponin T (hs-cTnT) and different cardiovascular events has been observed in several large community studies, and the results have been controversial. However, there is currently no cross-sectional or longitudinal follow-up study on hs-cTnT in the Chinese population. Methods. We analyzed the association of plasma hs-cTnT levels with major adverse cardiovascular events (MACEs) and all-cause mortality in 1325 subjects from a longitudinal follow-up community-based population in Beijing, China. Results. In the Cox proportional hazards models analysis, the risk of MACEs increased with the increase of hs-cTnT levels (HR, 1.223, 95% CI, 1.054–1.418, P = 0.008 ). Increased hs-cTnT levels were associated with coronary events (HR, 1.391, 95% CI, 1.106–1.749, P = 0.005 ) in Model 4. Cox proportional risk regression model analysis revealed that increased hs-cTnT levels were associated with an increased risk of mortality (HR, 1.763, 95% CI, 1.224–2.540, P = 0.002 ), even after adjusting hs-CRP and NT-proBNP. The area under the ROC curve for predicting MACEs was 0.559 (95% CI, 0.523–0.595, P = 0.001 ). The areas under the ROC curve for predicting coronary events and mortality were 0.629 (95% CI, 0.580–0.678, P < 0.001 ) and 0.644 (95% CI, 0.564–0.725, P < 0.001 ), respectively. Conclusions. Our findings in the Chinese cohort support that hs-cTnT is a risk factor for major adverse cardiovascular events and all-cause mortality.

2020 ◽  
Author(s):  
Xiaona Wang ◽  
Ruihua Cao ◽  
Xu Yang ◽  
Wenkai Xiao ◽  
Yun Zhang ◽  
...  

Abstract Background: The relationship between high-sensitivity cardiac troponin T (hs-cTnT) and different cardiovascular events has been observed in several large community studies, and the results have been controversial. However, there is currently no cross-sectional or longitudinal follow-up study on hs-cTnT in the Chinese population.Methods: We analyzed the association of plasma hs-cTnT levels with major adverse cardiovascular events and all-cause mortality in 1325 subjects from a longitudinal follow-up community-based population in Beijing, China.Results: In the Cox proportional hazards models analysis, the risk of MACE increased with the increase of hs-cTnT levels (HR, 1.223, 95% CI, 1.054–1.418, P = 0.008). Increased hs-cTnT levels were associated with coronary events (HR, 1.391, 95% CI, 1.106–1.749, P = 0.005) in Model 4. Cox proportional risk regression model analysis revealed that increased hs-cTnT levels were associated with an increased risk of mortality (HR, 1.763, 95% CI, 1.224–2.540, P = 0.002), even after adjusting hs-CRP and NT-proBNP. The area under the ROC curve for predicting MACE was 0.559 (95% CI, 0.523–0.595, P = 0.001). The areas under the ROC curve for predicting coronary events and mortality were 0.629 (95% CI, 0.580–0.678, P < 0.001) and 0.644 (95% CI, 0.564–0.725, P < 0.001), respectively.Conclusions: Our findings in the Chinese cohort support that hs-cTnT is a risk factor for major adverse cardiovascular events and all-cause mortality.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
R Arbucci ◽  
S Haseeb ◽  
R Campos ◽  
M Trivi ◽  
J P Costabel

Abstract Background Atrial Fibrillation (AF) is the most common sustained cardiac arrhythmia encountered in clinical practice and confers a significant burden to morbidity and mortality. High-sensitivity cardiac troponin T (hs-cTnT) levels have provided a significant contribution in the early diagnosis of cardiovascular events; however, the significance of hs-cTnT elevation in the setting of acute AF is not clearly understood. Purpose The aim of this study was to evaluate the factors associated with hs-cTnT elevation and its prognostic implication in patients with acute AF. Methods This single-center prospective study included 406 consecutive patients who presented to the emergency department (ED) with acute AF. Acute AF was defined as a rapid, irregular, and chaotic atrial activity of <48 hours' duration including both the first symptomatic onset of chronic or persistent AF, and episodes of paroxysmal AF. The association between hs-cTnT and outcomes were evaluated using multivariate analyses. Results The mean age of the population was 67.3±12.2 and 74% were male. The median time from the onset of symptoms to ED consultation was 230 minutes (interquartile range: 123–450 minutes). The median hs-cTnT value was 12 ng/L, with 39% of patients with values above the 99 thpercentile. AF was reverted to sinus rhythm in 76% of the patients (83% attempted cardioversion). At one-year, AF recurrence was observed in 38% of the patients and major adverse cardiovascular events (MACE) (death, myocardial infarction, acute coronary syndrome or stroke) were observed in 6% of the patients. After adjusting for demographic and clinical characteristics in multivariate analysis, hs-cTnT elevation was associated with increasing age and left atrial area (p=0.001). Hs-cTnT levels were not associated with 1-year AF recurrence (p=0.132) or with AF reversion (p=0.869). Hs-cTnT levels were significantly higher in patients who experienced MACE at 1-year (12 ng/L vs 24 ng/L, p=0.001) and hs-cTnT was a predictor of MACE on multivariate analysis (OR 3.486, 95% CI 1.256–5.379, p=0.009). Variable Result AF rate 110 (90–118) Atrial area, cm2 22 (19–27) Cardioversion attemped 82.5% Conclusions Hs-cTnT elevation accounted for a large proportion of patients with acute AF. Elevated levels of hs-cTnT were not associated with AF reversion or with 1-year AF recurrence, however hs-cTnT was highly predictive of MACE at 1-year.


2007 ◽  
Vol 53 (5) ◽  
pp. 882-889 ◽  
Author(s):  
Angela Yee-Moon Wang ◽  
Christopher Wai-Kei Lam ◽  
Mei Wang ◽  
Iris Hiu-Shuen Chan ◽  
William B Goggins ◽  
...  

Abstract Background: We investigated whether cardiac troponin T (cTnT) independently predicted outcome and added prognostic value over other clinical risk predictors in chronic peritoneal dialysis (PD) with end-stage renal disease. Methods: Baseline cTnT, echocardiography, indices of dialysis adequacy, and biochemical characteristics were assessed in 238 chronic PD patients who were followed prospectively for 3 years or until death. Results: Using multivariable Cox regression analysis, cTnT remained predictive of all-cause mortality [hazard ratio 4.43, 95% CI 1.87–10.45, P = 0.001], cardiovascular death (4.12, 1.29–13.17, P = 0.017), noncardiovascular death (8.06, 1.86–35.03, P = 0.005), and fatal and nonfatal cardiovascular events (CVEs) (3.59, 1.48–8.70, P = 0.005) independent of background coronary artery disease, inflammation, residual renal function, left ventricular hypertrophy, and systolic dysfunction. cTnT alone had better predictive value than C-reactive protein (CRP) alone for mortality [area under the ROC curve (AUC) 0.774 vs 0.691; P = 0.089] and first CVE (AUC 0.711 vs 0.593; P = 0.009) at 3 years. Survival models including age, sex, and clinical, biochemical, and echocardiographic characteristics yielded AUCs of 0.813 (95% CI, 0.748–0.877), 0.800 (95% CI, 0.726–0.874), and 0.769 (95% CI, 0.708–0.830), respectively, in relation to all-cause mortality, cardiovascular death, and fatal and nonfatal cardiovascular events. After addition of cTnT, AUCs of the above models increased significantly to 0.832 (95% CI, 0.669–0.894; P = 0.0037), 0.810 (95% CI, 0.739–0.883; P = 0.0036), and 0.780 (95% CI, 0.720–0.840; P = 0.0002), respectively; no AUCs increased when CRP was added. Conclusions: cTnT is an independent predictor of long-term mortality, cardiovascular death and events, and noncardiovascular death in PD patients.


Rheumatology ◽  
2020 ◽  
Author(s):  
Julie Chezel ◽  
Nathalie Costedoat-Chalumeau ◽  
Cedric Laouénan ◽  
Diane Rouzaud ◽  
Camille Chenevier-Gobeaux ◽  
...  

Abstract Objective Identification of biological markers able to better stratify cardiovascular risks in SLE patients is needed. We aimed to determine whether serum cardiac troponin T (cTnT) levels measured with a highly sensitive assay [high sensitivity cTnT (HS-cTnT)] may predict cardiovascular events (CVEs) in SLE. Method All SLE patients included between 2007 and 2010 in the randomized, double-blind, placebo-controlled, multicentre PLUS trial were screened. Patients with no past history of CVE at inclusion and a follow-up period of &gt;20 months were analysed. HS-cTnT concentration was measured using the electrochemiluminescence method on serum collected at PLUS inclusion. The primary outcome was the incident CVE. Factors associated with the primary outcome were identified and multivariate analysis was performed. Results Overall, 442 SLE patients (of the 573 included in the PLUS study) were analysed for the primary outcome with a median follow up of 110 (interquartile range: 99–120) months. Among them, 29 (6.6%) experienced at least one CVE that occurred at a median of 67 (interquartile range: 31–91) months after inclusion. Six out of 29 patients had more than one CVE. In the multivariate analysis, dyslipidaemia, age and HS-cTnT were associated with the occurrence of CVE. Kaplan–Meier analysis showed that a concentration of HS-cTnT &gt; 4.27 ng/l at inclusion increased by 2.7 [hazard ratio 2.7 (95% CI: 1.3, 5.6), P =0.0083] the risk of CVE in SLE. Conclusion HS-cTnT measured in serum is the first identified biomarker independently associated with incident CVE in SLE patients.


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