TY - JOUR
T1 - Patterns and determinants of temporal change in high-sensitivity cardiac troponin-T
T2 - The Atherosclerosis Risk in Communities Cohort Study
AU - McEvoy, John W.
AU - Lazo, Mariana
AU - Chen, Yuan
AU - Shen, Lu
AU - Nambi, Vijay
AU - Hoogeveen, Ron C.
AU - Ballantyne, Christie M.
AU - Blumenthal, Roger S.
AU - Coresh, Josef
AU - Selvin, Elizabeth
N1 - Publisher Copyright:
© 2015 Published by Elsevier Ireland Ltd.
PY - 2015/5/6
Y1 - 2015/5/6
N2 - Background: Patterns and determinants of temporal change in highly-sensitivity troponin-T (hs-cTNT), a novel measure of subclinical myocardial injury, among asymptomatic persons have not been well characterized. Methods:Westudied 8571 ARIC Study participants, free of cardiovascular disease, who had hs-cTNT measured at two time-points, 6 years apart (1990.1992 and 1996.1998). We examined the association of baseline 10-year atherosclerotic cardiovascular (ASCVD) risk-group (<5%, 5.7.4%, ≥7.5%) and individual cardiac risk-factors with change across hs-cTNT categories using Poisson and Multinomial Logistic regression and with mean continuous hs-cTNT change using linear regression. Results: Mean agewas 57 years and 43% were male.Mean (SD) 6-year hs-cTNT changewas higher across increasing ASCVD risk-groups; +1.2 (6.1) ng/L [>5%], +2.1 (5.4) ng/L [5.7.4%], and +2.8 (8.8) ng/L [≥7.5%]. Major baseline determinants of temporal hs-cTNT increaseswere: age, male gender, hypertension, diabetes, and obesity. In addition, the relative risk (RR) of incident elevated hs-cTNT (≥14 ng/L) was 1.46 (95% CI 1.1.2.0) for personswith sustained hypertension compared to those who remained normotensive. Results for sustained obesity (RR 1.65 [1.19.2.29]) and hyperglycemia (RR 1.76 [1.16.2.67]) were similar. These associations were generally stronger after accounting for survival bias. However, smoking, LDL-cholesterol and triglycerideswere not associated with hs-cTNT change. HDL-cholesterol was associated with declining hs-cTNT. Conclusions: Persons in higher ASCVD risk-groups were more likely to have increases in hs-cTNT over 6 years of follow-up. The modifiable risk-factors primarily driving this association were diabetes, hypertension, and obesity; particularly when they were persistently elevated over follow-up. Future studies are needed to determine whether modifying these risk factors can prevent progression of subclinical myocardial injury.
AB - Background: Patterns and determinants of temporal change in highly-sensitivity troponin-T (hs-cTNT), a novel measure of subclinical myocardial injury, among asymptomatic persons have not been well characterized. Methods:Westudied 8571 ARIC Study participants, free of cardiovascular disease, who had hs-cTNT measured at two time-points, 6 years apart (1990.1992 and 1996.1998). We examined the association of baseline 10-year atherosclerotic cardiovascular (ASCVD) risk-group (<5%, 5.7.4%, ≥7.5%) and individual cardiac risk-factors with change across hs-cTNT categories using Poisson and Multinomial Logistic regression and with mean continuous hs-cTNT change using linear regression. Results: Mean agewas 57 years and 43% were male.Mean (SD) 6-year hs-cTNT changewas higher across increasing ASCVD risk-groups; +1.2 (6.1) ng/L [>5%], +2.1 (5.4) ng/L [5.7.4%], and +2.8 (8.8) ng/L [≥7.5%]. Major baseline determinants of temporal hs-cTNT increaseswere: age, male gender, hypertension, diabetes, and obesity. In addition, the relative risk (RR) of incident elevated hs-cTNT (≥14 ng/L) was 1.46 (95% CI 1.1.2.0) for personswith sustained hypertension compared to those who remained normotensive. Results for sustained obesity (RR 1.65 [1.19.2.29]) and hyperglycemia (RR 1.76 [1.16.2.67]) were similar. These associations were generally stronger after accounting for survival bias. However, smoking, LDL-cholesterol and triglycerideswere not associated with hs-cTNT change. HDL-cholesterol was associated with declining hs-cTNT. Conclusions: Persons in higher ASCVD risk-groups were more likely to have increases in hs-cTNT over 6 years of follow-up. The modifiable risk-factors primarily driving this association were diabetes, hypertension, and obesity; particularly when they were persistently elevated over follow-up. Future studies are needed to determine whether modifying these risk factors can prevent progression of subclinical myocardial injury.
KW - Biomarker
KW - High-sensitivity troponin
KW - Subclinical myocardial injury
KW - Temporal change
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U2 - 10.1016/j.ijcard.2015.03.436
DO - 10.1016/j.ijcard.2015.03.436
M3 - Article
C2 - 25880403
AN - SCOPUS:84929190759
SN - 0167-5273
VL - 187
SP - 651
EP - 657
JO - International Journal of Cardiology
JF - International Journal of Cardiology
IS - 1
ER -