High population prevalence of cardiac troponin I measured by a high-sensitivity assay and cardiovascular risk estimation: the MORGAM Biomarker Project Scottish Cohort

Our aim was to test the prediction and clinical applicability of high-sensitivity assayed troponin I for incident cardiovascular events in a general middle-aged European population. High-sensitivity assayed troponin I was measured in the Scottish Heart Health Extended Cohort (n = 15 340) with 2171 c...

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Vydáno v:European heart journal Ročník 35; číslo 5; s. 271
Hlavní autoři: Zeller, Tanja, Tunstall-Pedoe, Hugh, Saarela, Olli, Ojeda, Francisco, Schnabel, Renate B, Tuovinen, Tarja, Woodward, Mark, Struthers, Allan, Hughes, Maria, Kee, Frank, Salomaa, Veikko, Kuulasmaa, Kari, Blankenberg, Stefan
Médium: Journal Article
Jazyk:angličtina
Vydáno: England 01.02.2014
Témata:
Biomarkers - blood
Cardiovascular Diseases - blood
Cardiovascular Diseases - mortality
Cohort Studies
Female
Humans
Immunoassay - methods
Male
Middle Aged
Myocardial Infarction - blood
Myocardial Infarction - mortality
Prevalence
Risk Assessment
Scotland - epidemiology
Sex Distribution
Stroke - blood
Stroke - mortality
Troponin I - blood
Scotland
High-sensitivity assayed troponin I
MONICA Risk Genetics Archiving and Monograph (MORGAM)
Mortality
Cardiovascular risk
Scottish Heart Health Extended Cohort (SHHEC)
ISSN:1522-9645, 1522-9645
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Shrnutí:Our aim was to test the prediction and clinical applicability of high-sensitivity assayed troponin I for incident cardiovascular events in a general middle-aged European population. High-sensitivity assayed troponin I was measured in the Scottish Heart Health Extended Cohort (n = 15 340) with 2171 cardiovascular events (including acute coronary heart disease and probable ischaemic strokes), 714 coronary deaths (25% of all deaths), 1980 myocardial infarctions, and 797 strokes of all kinds during an average of 20 years follow-up. Detection rate above the limit of detection (LoD) was 74.8% in the overall population and 82.6% in men and 67.0% in women. Troponin I assayed by the high-sensitivity method was associated with future cardiovascular risk after full adjustment such as that individuals in the fourth category had 2.5 times the risk compared with those without detectable troponin I (P < 0.0001). These associations remained significant even for those individuals in whom levels of contemporary-sensitivity troponin I measures were not detectable. Addition of troponin I levels to clinical variables led to significant increases in risk prediction with significant improvement of the c-statistic (P < 0.0001) and net reclassification (P < 0.0001). A threshold of 4.7 pg/mL in women and 7.0 pg/mL in men is suggested to detect individuals at high risk for future cardiovascular events. Troponin I, measured with a high-sensitivity assay, is an independent predictor of cardiovascular events and might support selection of at risk individuals.
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ISSN:1522-9645
1522-9645
DOI:10.1093/eurheartj/eht406