Abstract MP26: Highly Sensitive Cardiac Troponin T is Associated with Cognitive Function and Incidence of Dementia

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Andrea L Schneider ◽  
Andreea M Rawlings ◽  
A. R Sharrett ◽  
Alvaro Alonso ◽  
Thomas Mosley ◽  
...  
Keyword(s):  
Test Scores ◽  
Cardiac Troponin ◽  
Troponin T ◽  
Myocardial Damage ◽  
Cognitive Test ◽  
Cardiac Troponin T ◽  
Cross Sectional ◽  
Dementia Risk ◽  
Highly Sensitive

Introduction: Clinical cardiovascular disease is a major risk factor for cognitive impairment and dementia, but less is known about the association of subclinical myocardial damage (measured by highly sensitive cardiac troponin T [hs-cTnT]) with cognition and dementia in the general population. Hypothesis: We hypothesized that higher levels of hs-cTnT would be associated with lower cognitive test scores and increased risk of dementia. Methods: We conducted cross-sectional (1996-1998) and prospective (follow-up through 2009) analyses of 8,601 participants in the ARIC Study without a history of cardiovascular disease or stroke. Cognition was measured by 3 tests: Delayed Word Recall (DWR), Digit Symbol Substitution (DSS), and Word Fluency (WF). Dementia was defined using ICD-9 codes. Linear regression and Cox proportional hazards models were adjusted for demographic, lifestyle, and cardiovascular factors. Results: 66% of participants had detectable hs-cTnT (≥0.003 μg/L) (mean age 63; 59% female; 20% black). In cross-sectional analyses, higher hs-cTnT was associated with lower scores on DSS (p-trend <0.001) and WF (p-trend=0.002), but not DWR (p-trend=0.09) (Table). Similarly, hs-cTnT ≥0.014 μg/L (≥99th percentile) vs. <0.014 μg/L was associated with lower scores on DSS (-1.78 points [95% CI: -2.61, -0.95]) and WF (-1.04 words [95% CI: -2.00, -0.07]), but not on DWR. Over a median of 12 years, there were 338 incident dementia cases. In prospective analyses, higher baseline levels of hs-cTnT were associated with increased dementia risk (p-trend <0.001) (Table). Conclusion: Higher levels of hs-cTnT were associated with lower cognitive test scores at baseline and increased dementia risk during follow-up. Our results suggest that subclinical myocardial damage is associated with cognition and dementia. This association may be driven by shared risk factors for myocardial and cerebral injury or as a direct result of subclinical small vessel or cardiac disease; more work is needed to elucidate potential mechanisms.

scholarly journals Estimated Glomerular Filtration Rate is a Predictive Factor for High-Sensitivity Cardiac Troponin T in a Community-Based 4.8-year Prospective Study

2020 ◽  
Author(s):  
Jie Han ◽  
Xiaona Wang ◽  
Ping Ye ◽  
Ruihua Cao ◽  
Wenkai Xiao ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
Filtration Rate ◽  
Myocardial Injury ◽  
Estimated Glomerular Filtration Rate ◽  
Troponin T ◽  
Cardiac Troponin T ◽  
Community Based ◽  
Highly Sensitive ◽  
The Relationship

Abstract Objectives: Persistent elevation of cardiac troponin T (cTnT), which is considered as a sensitive and specific biomarker of myocardial injury, is frequently observed in patients with renal insufficiency. Meanwhile, estimated glomerular filtration rate (eGFR) is an independent risk factor of cardiovascular diseases. With a highly sensitive assay, the prevalence of detectable highly sensitive cTnT (hs-cTnT) is greatly improved even in general population. The aim of this study was to better understand the relationship between renal function (eGFR) and myocardial injury (hs-cTnT) in a community-based population.Methods: We analyzed the relationship between baseline eGFR and follow-up hs-cTnT, and the change of hs-cTnT in 1354 participants after 4.8 years follow-up.Results: In Pearson’s correlation analysis, baseline eGFR showed a negative relationship with follow-up hs-cTnT (r=-0.439; P < 0.001). In multiple linear regression analysis, baseline eGFR was independently and negatively associated with follow-up hs-cTnT (β=-0.310, P = 0.005). Stepwise logistic regression models revealed that baseline eGFR was significantly associated with the change in hs-cTnT after 4.8 years follow-up. However, the change in eGFR was not associated with the change in hs-cTnT.Conclusions: Baseline eGFR levels were independently and negatively associated with follow-up hs-cTnT. Furthermore, baseline eGFR levels were an independent predictor of the change in hs-cTnT 4.8 years follow-up, indicating a relationship between renal function and myocardial injury in a community-based population.

Highly sensitive serum cardiac troponin T and cardiovascular events in patients with systemic lupus erythematosus (TROPOPLUS study)

Rheumatology ◽  
2020 ◽  
Author(s):  
Julie Chezel ◽  
Nathalie Costedoat-Chalumeau ◽  
Cedric Laouénan ◽  
Diane Rouzaud ◽  
Camille Chenevier-Gobeaux ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Cardiac Troponin ◽  
Cardiovascular Events ◽  
Primary Outcome ◽  
Troponin T ◽  
Interquartile Range ◽  
Cardiac Troponin T ◽  
Highly Sensitive ◽  
Serum Cardiac Troponin

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.

scholarly journals SAT0201 ASSOCIATION OF CARDIAC TROPONIN T MEASURED WITH A HIGHLY SENSITIVE ASSAY WITH CARDIOVASCULAR EVENTS IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS (TROPOPLUS STUDY)

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1043.1-1043
Author(s):  
J. Chezel ◽  
N. Costedoat-Chalumeau ◽  
D. Rouzaud ◽  
V. Le Guern ◽  
C. Gobeaux ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Cardiac Troponin ◽  
Primary Outcome ◽  
Troponin T ◽  
Cardiac Troponin T ◽  
Sensitive Assay ◽  
Systemic Lupus ◽  
Research Support ◽  
Highly Sensitive

Background:Mortality is still 2 to 5 times superior in SLE patients as compared to general population and is mainly due to cardiovascular event (CVE). Although cardiovascular traditional risk factors contribute to early-onset atherosclerosis in SLE, the phenomenon is not fully explained by a higher frequency of smoking habits, hypertension, or dyslipidemia and the Framingham risk equation usually underestimates the 10-year cardiovascular risk in this population. Thus, identification of biological markers able to better stratify cardiovascular risks in SLE patients is needed.Objectives:Our study aimed to determine whether serum cardiac troponin T measured with a highly sensitive assay (HS-cTnT) was associated with CVE in systemic lupus erythematosus (SLE) patients.Methods:All SLE patients included between 2007 and 2010 in the randomized, double-blind, placebo-controlled, multicenter PLUS trial were retrospectively screened. Patients with no past history of CVE and a follow-up period of > 20 months were analyzed. 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 analyzed for the primary outcome with a median follow up of 110 (IQR: 99-120) months. Among them 29 (6.6%) experienced at least one CVE that occurred at a median of 67 (IQR: 31-91) months after inclusion. Six out of 29 patients had more than one CVE. In the multivariate analysis, dyslipidemia, duration of SLE disease and HS-cTnT were associated with the occurrence of CVE. Kaplan-Meier analysis showed that a concentration of HS-cTnT>4.27 ng/L at inclusion increased by 2.7 (HR 2.7 [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 patientsDisclosure of Interests:Julie Chezel: None declared, Nathalie Costedoat-Chalumeau Grant/research support from: UCB to my institution, Diane Rouzaud: None declared, Véronique LE GUERN Grant/research support from: UCB for GR2 study (to our institution), Camille Gobeaux: None declared, Nathalie Morel: None declared, Micheline Pha: None declared, Zahir Amoura: None declared, Thomas Papo: None declared, karim sacre: None declared

scholarly journals Prognostic Value of Combination of Cardiac Troponin T and B-Type Natriuretic Peptide after Initiation of Treatment in Patients with Chronic Heart Failure

2003 ◽  
Vol 49 (12) ◽  
pp. 2020-2026 ◽  
Author(s):  
Junnichi Ishii ◽  
Wei Cui ◽  
Fumihiko Kitagawa ◽  
Takahiro Kuno ◽  
Yuu Nakamura ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Cardiac Troponin ◽  
Troponin T ◽  
Myocardial Damage ◽  
Left Ventricular ◽  
Functional Class ◽  
Cardiac Troponin T ◽  
Cardiac Events ◽  
Nyha Functional Class

Abstract Background: Recent studies have suggested that cardiac troponin T (cTnT) and troponin I may detect ongoing myocardial damage involved in the progression of chronic heart failure (CHF). This study was prospectively designed to examine whether the combination of cTnT, a marker for ongoing myocardial damage, and B-type natriuretic peptide (BNP), a marker for left ventricular overload, would effectively stratify patients with CHF after initiation of treatment. Methods: We measured serum cTnT, plasma BNP, and left ventricular ejection fraction (LVEF) on admission for worsening CHF [New York Heart Association (NYHA) functional class III to IV] and 2 months after initiation of treatment to stabilize CHF (n = 100; mean age, 68 years). Results: Mean (SD) concentrations of cTnT [0.023 (0.066) vs 0.063 (0.20) μg/L] and BNP [249 (276) vs 753 (598) ng/L], percentage increased cTnT (&gt;0.01 μg/L; 35% vs 60%), NYHA functional class [2.5 (0.6) vs 3.5 (5)], and LVEF [43 (13)% vs 36 (12)%] were significantly (P &lt;0.01) improved 2 months after treatment compared with admission. During a mean follow-up of 391 days, there were 44 cardiac events, including 12 cardiac deaths and 32 readmissions for worsening CHF. On a stepwise Cox regression analysis, increased cTnT and BNP were independent predictors of cardiac events (P &lt;0.001). cTnT &gt;0.01 μg/L and/or BNP &gt;160 ng/L 2 months after initiation of treatment were associated with increased cardiac mortality and morbidity rates. Conclusion: The combination of cTnT and BNP measurements after initiation of treatment may be highly effective for risk stratification in patients with CHF.

scholarly journals Ethnicity-Specific Changes in Cardiac Troponin T in Response to Acute Mental Stress and Ethnicity-Specific Cutpoints for the R Wave of the aVL Lead

2019 ◽  
Vol 188 (8) ◽  
pp. 1444-1455 ◽  
Author(s):  
Annemarie Wentzel ◽  
Leoné Malan ◽  
Roland von Känel ◽  
Nicolaas T Malan
Keyword(s):  
Blood Pressure ◽  
Stress Responses ◽  
Cardiac Troponin ◽  
Mental Stress ◽  
Troponin T ◽  
Myocardial Strain ◽  
Peripheral Resistance ◽  
Cardiac Troponin T ◽  
Cross Sectional ◽  
Cardiac Stress

Abstract Acute mental stressor–induced cardiac stress responses might contribute to excessive myocardial strain and resultant cardiovascular episode risk. We assessed ethnicity-specific acute cardiac stress (by measuring cardiac troponin T (cTnT) and N-terminal prohormone of brain natriuretic peptide) related to hemodynamic activity. The prospective Sympathetic Activity and Ambulatory Blood Pressure in Africans (SABPA) study was conducted during 2007–2008 in South Africa. In the cross-sectional phase of the SABPA study, 388 black and white participants underwent a 1-minute acute mental stressor, during which blood pressure was continuously measured. Fasting blood samples for cardiac stress markers were obtained before and 10 minutes after stress (% change). Resting 10-lead electrocardiogram measured the R wave of the aVL lead (RaVL). Black participants exhibited greater cardiac stress responses (P &lt; 0.001), diastolic blood pressure, total peripheral resistance, and stroke volume compared with white participants, who displayed decreases in cardiac stress and increases in cardiac output. Prestress and stressor cTnT cutpoints of 4.2 pg/mL predicted 24-hour, daytime, and nighttime diastolic hypertension in black participants (P &lt; 0.001). These cTnT cutpoints were associated with an ethnicity-specific RaVL cutpoint of 0.28 mV (odds ratio = 3.49, 95% confidence interval: 2.18, 5.83; P = 0.021). Acute mental stress elicited an α-adrenergic activation pattern and cardiac stress hyperreactivity only in black participants. Mental stress might increase the black population’s risk for ischemic episodes and heart disease.

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