High-Sensitivity Cardiac Troponin I Levels and Prediction of Heart Failure: Results From the BiomarCaRE Consortium

Isabell Yan; Christin S Börschel; Johannes T Neumann; Ngoc A Sprünker; Nataliya Makarova; Jukka Kontto; Kari Kuulasmaa; Veikko Salomaa; Christina Magnussen; Licia Iacoviello; Augusto Di Castelnuovo; Simona Costanzo; Allan Linneberg; Stefan Söderberg; Tanja Zeller; Francisco M Ojeda-Echevarria; Stefan Blankenberg; Dirk Westermann

doi:10.1016/j.jchf.2019.12.008

High-Sensitivity Cardiac Troponin I Levels and Prediction of Heart Failure: Results From the BiomarCaRE Consortium

Isabell Yan, Christin S Börschel, Johannes T Neumann, Ngoc A Sprünker, Nataliya Makarova, Jukka Kontto, Kari Kuulasmaa, Veikko Salomaa, Christina Magnussen, Licia Iacoviello, Augusto Di Castelnuovo, Simona Costanzo, Allan Linneberg, Stefan Söderberg, Tanja Zeller, Francisco M Ojeda-Echevarria, Stefan Blankenberg, Dirk Westermann

Center for Klinisk Forskning og Forebyggelse

46 Citationer (Scopus)

Abstract

OBJECTIVES: The aims of this study were to characterize the association of high-sensitivity cardiac troponin I (hs-cTnI) with heart failure (HF), to determine its predictive value beyond classical cardiovascular risk factors (CVRFs) and N-terminal pro-B-type natriuretic peptide, and to derive a relevant cutoff for potential clinical application.

BACKGROUND: HF is an important contributor to the overall burden of cardiovascular disease. Early identification of individuals at risk could be beneficial for preventive therapies.

METHODS: Based on the Biomarker for Cardiovascular Risk Assessment in Europe consortium, we analyzed individual-level data from 4 prospective population-based cohort studies including 48,455 individuals. Participants with myocardial infarction, HF, and stroke at baseline were excluded. We investigated the value of adding hs-cTnI to CVRFs and N-terminal pro-B-type natriuretic peptide using Cox proportional hazards survival models and for prediction by calculating C-statistics and Brier score.

RESULTS: The median age of the study population was 51 years, and the median follow-up time for occurrence of HF was 6.61 years. Cox regression models adjusted for age, sex, and CVRFs revealed a significant association of hs-cTnI with incident HF (hazard ratio: 1.42 per log [ng/l] unit change [95% confidence interval: 1.31 to 1.53]). The best predictive value was achieved in the model with CVRFs (base model) and both biomarkers (C-index = 0.862; 95% confidence interval: 0.841 to 0.882). Optimal hs-cTnI cutoff values of 2.6 ng/l for women and 4.2 ng/l for men were derived for selecting individuals at risk.

CONCLUSIONS: In this large dataset from the general population, hs-cTnI could show its independence for the prognosis of HF.

Originalsprog	Engelsk
Tidsskrift	JACC. Heart failure
Vol/bind	8
Udgave nummer	5
Sider (fra-til)	401-411
Antal sider	11
ISSN	2213-1779
DOI	https://doi.org/10.1016/j.jchf.2019.12.008
Status	Udgivet - maj 2020

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10.1016/j.jchf.2019.12.008

Citationsformater

Yan, I., Börschel, C. S., Neumann, J. T., Sprünker, N. A., Makarova, N., Kontto, J., Kuulasmaa, K., Salomaa, V., Magnussen, C., Iacoviello, L., Di Castelnuovo, A., Costanzo, S., Linneberg, A., Söderberg, S., Zeller, T., Ojeda-Echevarria, F. M., Blankenberg, S., & Westermann, D. (2020). High-Sensitivity Cardiac Troponin I Levels and Prediction of Heart Failure: Results From the BiomarCaRE Consortium. JACC. Heart failure, 8(5), 401-411. https://doi.org/10.1016/j.jchf.2019.12.008

Yan, I, Börschel, CS, Neumann, JT, Sprünker, NA, Makarova, N, Kontto, J, Kuulasmaa, K, Salomaa, V, Magnussen, C, Iacoviello, L, Di Castelnuovo, A, Costanzo, S, Linneberg, A, Söderberg, S, Zeller, T, Ojeda-Echevarria, FM, Blankenberg, S & Westermann, D 2020, 'High-Sensitivity Cardiac Troponin I Levels and Prediction of Heart Failure: Results From the BiomarCaRE Consortium', JACC. Heart failure, bind 8, nr. 5, s. 401-411. https://doi.org/10.1016/j.jchf.2019.12.008

@article{0122c8a167b34805a486a7d77341c72e,

title = "High-Sensitivity Cardiac Troponin I Levels and Prediction of Heart Failure: Results From the BiomarCaRE Consortium",

abstract = "OBJECTIVES: The aims of this study were to characterize the association of high-sensitivity cardiac troponin I (hs-cTnI) with heart failure (HF), to determine its predictive value beyond classical cardiovascular risk factors (CVRFs) and N-terminal pro-B-type natriuretic peptide, and to derive a relevant cutoff for potential clinical application.BACKGROUND: HF is an important contributor to the overall burden of cardiovascular disease. Early identification of individuals at risk could be beneficial for preventive therapies.METHODS: Based on the Biomarker for Cardiovascular Risk Assessment in Europe consortium, we analyzed individual-level data from 4 prospective population-based cohort studies including 48,455 individuals. Participants with myocardial infarction, HF, and stroke at baseline were excluded. We investigated the value of adding hs-cTnI to CVRFs and N-terminal pro-B-type natriuretic peptide using Cox proportional hazards survival models and for prediction by calculating C-statistics and Brier score.RESULTS: The median age of the study population was 51 years, and the median follow-up time for occurrence of HF was 6.61 years. Cox regression models adjusted for age, sex, and CVRFs revealed a significant association of hs-cTnI with incident HF (hazard ratio: 1.42 per log [ng/l] unit change [95% confidence interval: 1.31 to 1.53]). The best predictive value was achieved in the model with CVRFs (base model) and both biomarkers (C-index = 0.862; 95% confidence interval: 0.841 to 0.882). Optimal hs-cTnI cutoff values of 2.6 ng/l for women and 4.2 ng/l for men were derived for selecting individuals at risk.CONCLUSIONS: In this large dataset from the general population, hs-cTnI could show its independence for the prognosis of HF.",

author = "Isabell Yan and B{\"o}rschel, {Christin S} and Neumann, {Johannes T} and Spr{\"u}nker, {Ngoc A} and Nataliya Makarova and Jukka Kontto and Kari Kuulasmaa and Veikko Salomaa and Christina Magnussen and Licia Iacoviello and {Di Castelnuovo}, Augusto and Simona Costanzo and Allan Linneberg and Stefan S{\"o}derberg and Tanja Zeller and Ojeda-Echevarria, {Francisco M} and Stefan Blankenberg and Dirk Westermann",

year = "2020",

month = may,

doi = "10.1016/j.jchf.2019.12.008",

language = "English",

volume = "8",

pages = "401--411",

journal = "JACC. Heart failure",

issn = "2213-1779",

publisher = "Elsevier BV",

number = "5",

}

TY - JOUR

T1 - High-Sensitivity Cardiac Troponin I Levels and Prediction of Heart Failure

T2 - Results From the BiomarCaRE Consortium

AU - Yan, Isabell

AU - Börschel, Christin S

AU - Neumann, Johannes T

AU - Sprünker, Ngoc A

AU - Makarova, Nataliya

AU - Kontto, Jukka

AU - Kuulasmaa, Kari

AU - Salomaa, Veikko

AU - Magnussen, Christina

AU - Iacoviello, Licia

AU - Di Castelnuovo, Augusto

AU - Costanzo, Simona

AU - Linneberg, Allan

AU - Söderberg, Stefan

AU - Zeller, Tanja

AU - Ojeda-Echevarria, Francisco M

AU - Blankenberg, Stefan

AU - Westermann, Dirk

PY - 2020/5

Y1 - 2020/5

N2 - OBJECTIVES: The aims of this study were to characterize the association of high-sensitivity cardiac troponin I (hs-cTnI) with heart failure (HF), to determine its predictive value beyond classical cardiovascular risk factors (CVRFs) and N-terminal pro-B-type natriuretic peptide, and to derive a relevant cutoff for potential clinical application.BACKGROUND: HF is an important contributor to the overall burden of cardiovascular disease. Early identification of individuals at risk could be beneficial for preventive therapies.METHODS: Based on the Biomarker for Cardiovascular Risk Assessment in Europe consortium, we analyzed individual-level data from 4 prospective population-based cohort studies including 48,455 individuals. Participants with myocardial infarction, HF, and stroke at baseline were excluded. We investigated the value of adding hs-cTnI to CVRFs and N-terminal pro-B-type natriuretic peptide using Cox proportional hazards survival models and for prediction by calculating C-statistics and Brier score.RESULTS: The median age of the study population was 51 years, and the median follow-up time for occurrence of HF was 6.61 years. Cox regression models adjusted for age, sex, and CVRFs revealed a significant association of hs-cTnI with incident HF (hazard ratio: 1.42 per log [ng/l] unit change [95% confidence interval: 1.31 to 1.53]). The best predictive value was achieved in the model with CVRFs (base model) and both biomarkers (C-index = 0.862; 95% confidence interval: 0.841 to 0.882). Optimal hs-cTnI cutoff values of 2.6 ng/l for women and 4.2 ng/l for men were derived for selecting individuals at risk.CONCLUSIONS: In this large dataset from the general population, hs-cTnI could show its independence for the prognosis of HF.

AB - OBJECTIVES: The aims of this study were to characterize the association of high-sensitivity cardiac troponin I (hs-cTnI) with heart failure (HF), to determine its predictive value beyond classical cardiovascular risk factors (CVRFs) and N-terminal pro-B-type natriuretic peptide, and to derive a relevant cutoff for potential clinical application.BACKGROUND: HF is an important contributor to the overall burden of cardiovascular disease. Early identification of individuals at risk could be beneficial for preventive therapies.METHODS: Based on the Biomarker for Cardiovascular Risk Assessment in Europe consortium, we analyzed individual-level data from 4 prospective population-based cohort studies including 48,455 individuals. Participants with myocardial infarction, HF, and stroke at baseline were excluded. We investigated the value of adding hs-cTnI to CVRFs and N-terminal pro-B-type natriuretic peptide using Cox proportional hazards survival models and for prediction by calculating C-statistics and Brier score.RESULTS: The median age of the study population was 51 years, and the median follow-up time for occurrence of HF was 6.61 years. Cox regression models adjusted for age, sex, and CVRFs revealed a significant association of hs-cTnI with incident HF (hazard ratio: 1.42 per log [ng/l] unit change [95% confidence interval: 1.31 to 1.53]). The best predictive value was achieved in the model with CVRFs (base model) and both biomarkers (C-index = 0.862; 95% confidence interval: 0.841 to 0.882). Optimal hs-cTnI cutoff values of 2.6 ng/l for women and 4.2 ng/l for men were derived for selecting individuals at risk.CONCLUSIONS: In this large dataset from the general population, hs-cTnI could show its independence for the prognosis of HF.

U2 - 10.1016/j.jchf.2019.12.008

DO - 10.1016/j.jchf.2019.12.008

M3 - Journal article

C2 - 32171759

SN - 2213-1779

VL - 8

SP - 401

EP - 411

JO - JACC. Heart failure

JF - JACC. Heart failure

IS - 5

ER -

High-Sensitivity Cardiac Troponin I Levels and Prediction of Heart Failure: Results From the BiomarCaRE Consortium

Abstract

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