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
N1 - Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.
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.
UR - https://www.scopus.com/pages/publications/85083331601
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 -