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Patterns and determinants of temporal change in high-sensitivity cardiac troponin-T: The Atherosclerosis Risk in Communities Cohort Study
Journal article   Open access   Peer reviewed

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 and Elizabeth Selvin
International journal of cardiology, v 187(1), pp 651-657
06 May 2015
DOI: https://doi.org/10.1016/j.ijcard.2015.03.436
PMID: 25880403
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://europepmc.org/articles/pmc4442046View
Accepted (AM)Open Access (License Unspecified),  Open

Abstract

Biomarker High-sensitivity troponin Subclinical myocardial injury Temporal change
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. We studied 8571 ARIC Study participants, free of cardiovascular disease, who had hs-cTNT measured at two time-points, 6years 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. Mean age was 57years and 43% were male. Mean (SD) 6-year hs-cTNT change was 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 increases were: age, male gender, hypertension, diabetes, and obesity. In addition, the relative risk (RR) of incident elevated hs-cTNT (≥14ng/L) was 1.46 (95% CI 1.1–2.0) for persons with 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 triglycerides were not associated with hs-cTNT change. HDL-cholesterol was associated with declining hs-cTNT. Persons in higher ASCVD risk-groups were more likely to have increases in hs-cTNT over 6years 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. •This is the first study to focus on long-term temporal change in hs-cTNT.•Expected hs-cTNT change in asymptomatic persons differs by demographics.•Major risk factors for hs-cTNT change are hypertension, diabetes, & obesity.•These results provide insights into myocardial injury and heart failure prevention.•Hs-cTNT may also be useful for monitoring therapies or as a surrogate marker.

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34 citations in Web of Science
39 citations in Scopus

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#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Cardiac & Cardiovascular Systems
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