Patterns and determinants of temporal change in high-sensitivity cardiac troponin-T: The Atherosclerosis Risk in Communities Cohort Study

John W. McEvoy, Mariana Lazo, Yuan Chen, Lu Shen, Vijay Nambi, Ron C. Hoogeveen, Christie M. Ballantyne, Roger S. Blumenthal, Josef Coresh, Elizabeth Selvin

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)651-657
Number of pages7
JournalInternational Journal of Cardiology
Volume187
Issue number1
DOIs
StatePublished - May 6 2015

Keywords

  • Biomarker
  • High-sensitivity troponin
  • Subclinical myocardial injury
  • Temporal change

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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