Cardiac troponin T measured by a highly sensitive assay predicts coronary heart disease, heart failure, and mortality in the atherosclerosis risk in communities study

Justin T. Saunders, Vijay Nambi, James A. De Lemos, Lloyd E. Chambless, Salim S. Virani, Eric Boerwinkle, Ron C. Hoogeveen, Xiaoxi Liu, Brad C. Astor, Thomas H. Mosley, Aaron R. Folsom, Gerardo Heiss, Josef Coresh, Christie M. Ballantyne

Research output: Contribution to journalArticle

Abstract

Background- We evaluated whether cardiac troponin T (cTnT) measured with a new highly sensitive assay was associated with incident coronary heart disease (CHD), mortality, and hospitalization for heart failure (HF) in a general population of participants in the Atherosclerosis Risk in Communities (ARIC) Study. Methods and Results- Associations between increasing cTnT levels and CHD, mortality, and HF hospitalization were evaluated with Cox proportional hazards models adjusted for traditional CHD risk factors, kidney function, high-sensitivity C-reactive protein, and N-terminal pro-B-type natriuretic peptide in 9698 participants aged 54 to 74 years who at baseline were free from CHD and stroke (and HF in the HF analysis). Measurable cTnT levels (0.003 μg/L) were detected in 66.5% of individuals. In fully adjusted models, compared with participants with undetectable levels, those with cTnT levels in the highest category (0.014 μg/L; 7.4% of the ARIC population) had significantly increased risk for CHD (hazard ratio=2.29; 95% confidence interval, 1.81 to 2.89), fatal CHD (hazard ratio=7.59; 95% confidence interval, 3.78 to 15.25), total mortality (hazard ratio=3.96; 95% confidence interval, 3.21 to 4.88), and HF (hazard ratio=5.95; 95% confidence interval, 4.47 to 7.92). Even minimally elevated cTnT (0.003 μg/L) was associated with increased risk for mortality and HF (P

Original languageEnglish (US)
Pages (from-to)1367-1376
Number of pages10
JournalCirculation
Volume123
Issue number13
DOIs
StatePublished - Apr 5 2011

Fingerprint

Troponin T
Coronary Disease
Atherosclerosis
Heart Failure
Mortality
Confidence Intervals
Hospitalization
Brain Natriuretic Peptide
Proportional Hazards Models
C-Reactive Protein
Population
Stroke
Kidney

Keywords

  • biomarkers
  • coronary disease
  • heart failure
  • risk factors
  • troponin T

ASJC Scopus subject areas

  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

Cite this

Cardiac troponin T measured by a highly sensitive assay predicts coronary heart disease, heart failure, and mortality in the atherosclerosis risk in communities study. / Saunders, Justin T.; Nambi, Vijay; De Lemos, James A.; Chambless, Lloyd E.; Virani, Salim S.; Boerwinkle, Eric; Hoogeveen, Ron C.; Liu, Xiaoxi; Astor, Brad C.; Mosley, Thomas H.; Folsom, Aaron R.; Heiss, Gerardo; Coresh, Josef; Ballantyne, Christie M.

In: Circulation, Vol. 123, No. 13, 05.04.2011, p. 1367-1376.

Research output: Contribution to journalArticle

Saunders, JT, Nambi, V, De Lemos, JA, Chambless, LE, Virani, SS, Boerwinkle, E, Hoogeveen, RC, Liu, X, Astor, BC, Mosley, TH, Folsom, AR, Heiss, G, Coresh, J & Ballantyne, CM 2011, 'Cardiac troponin T measured by a highly sensitive assay predicts coronary heart disease, heart failure, and mortality in the atherosclerosis risk in communities study', Circulation, vol. 123, no. 13, pp. 1367-1376. https://doi.org/10.1161/CIRCULATIONAHA.110.005264
Saunders, Justin T. ; Nambi, Vijay ; De Lemos, James A. ; Chambless, Lloyd E. ; Virani, Salim S. ; Boerwinkle, Eric ; Hoogeveen, Ron C. ; Liu, Xiaoxi ; Astor, Brad C. ; Mosley, Thomas H. ; Folsom, Aaron R. ; Heiss, Gerardo ; Coresh, Josef ; Ballantyne, Christie M. / Cardiac troponin T measured by a highly sensitive assay predicts coronary heart disease, heart failure, and mortality in the atherosclerosis risk in communities study. In: Circulation. 2011 ; Vol. 123, No. 13. pp. 1367-1376.
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abstract = "Background- We evaluated whether cardiac troponin T (cTnT) measured with a new highly sensitive assay was associated with incident coronary heart disease (CHD), mortality, and hospitalization for heart failure (HF) in a general population of participants in the Atherosclerosis Risk in Communities (ARIC) Study. Methods and Results- Associations between increasing cTnT levels and CHD, mortality, and HF hospitalization were evaluated with Cox proportional hazards models adjusted for traditional CHD risk factors, kidney function, high-sensitivity C-reactive protein, and N-terminal pro-B-type natriuretic peptide in 9698 participants aged 54 to 74 years who at baseline were free from CHD and stroke (and HF in the HF analysis). Measurable cTnT levels (0.003 μg/L) were detected in 66.5{\%} of individuals. In fully adjusted models, compared with participants with undetectable levels, those with cTnT levels in the highest category (0.014 μg/L; 7.4{\%} of the ARIC population) had significantly increased risk for CHD (hazard ratio=2.29; 95{\%} confidence interval, 1.81 to 2.89), fatal CHD (hazard ratio=7.59; 95{\%} confidence interval, 3.78 to 15.25), total mortality (hazard ratio=3.96; 95{\%} confidence interval, 3.21 to 4.88), and HF (hazard ratio=5.95; 95{\%} confidence interval, 4.47 to 7.92). Even minimally elevated cTnT (0.003 μg/L) was associated with increased risk for mortality and HF (P",
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AU - Virani, Salim S.

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