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Cardiac Troponin I and Incident Stroke in European Cohorts: Insights From the BiomarCaRE Project

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BiomarCaRE Consortium. / Cardiac Troponin I and Incident Stroke in European Cohorts : Insights From the BiomarCaRE Project. In: Stroke. 2020 ; Vol. 51, No. 9. pp. 2770-2777.

Bibtex

@article{1d84cd3467b146bab027ff06f9799f91,
title = "Cardiac Troponin I and Incident Stroke in European Cohorts: Insights From the BiomarCaRE Project",
abstract = "BACKGROUND AND PURPOSE: Stroke is a common cause of death and a leading cause of disability and morbidity. Stroke risk assessment remains a challenge, but circulating biomarkers may improve risk prediction. Controversial evidence is available on the predictive ability of troponin concentrations and the risk of stroke in the community. Furthermore, reports on the predictive value of troponin concentrations for different stroke subtypes are scarce.METHODS: High-sensitivity cardiac troponin I (hsTnI) concentrations were assessed in 82 881 individuals (median age, 50.7 years; 49.7{\%} men) free of stroke or myocardial infarction at baseline from 9 prospective European community cohorts. We used Cox proportional hazards regression to determine relative risks, followed by measures of discrimination and reclassification using 10-fold cross-validation to control for overoptimism. Follow-up was based upon linkage with national hospitalization registries and causes of death registries.RESULTS: Over a median follow-up of 12.7 years, 3033 individuals were diagnosed with incident nonfatal or fatal stroke (n=1654 ischemic strokes, n=612 hemorrhagic strokes, and n=767 indeterminate strokes). In multivariable regression models, hsTnI concentrations were associated with overall stroke (hazard ratio per 1-SD increase, 1.15 [95{\%} CI, 1.10-1.21]), ischemic stroke (hazard ratio, 1.14 [95{\%} CI, 1.09-1.21]), and hemorrhagic stroke (hazard ratio, 1.10 [95{\%} CI, 1.01-1.20]). Adding hsTnI concentrations to classical cardiovascular risk factors (C indices, 0.809, 0.840, and 0.736 for overall, ischemic, and hemorrhagic stroke, respectively) increased the C index significantly but modestly. In individuals with an intermediate 10-year risk (5{\%}-20{\%}), the net reclassification improvement for overall stroke was 0.038 (P=0.021).CONCLUSIONS: Elevated hsTnI concentrations are associated with an increased risk of incident stroke in the community, irrespective of stroke subtype. Adding hsTnI concentrations to classical risk factors only modestly improved estimation of 10-year risk of stroke in the overall cohort but might be of some value in individuals at an intermediate risk.",
author = "Stephan Camen and Tarja Palosaari and Jaakko Reinikainen and Spr{\"u}nker, {Ngoc Anh} and Teemu Niiranen and Francesco Gianfagna and Vishram-Nielsen, {Julie K K} and Simona Costanzo and Stefan S{\"o}derberg and Luigi Palmieri and Marco Ferrario and Annette Peters and Erkki Vartiainen and Donati, {Maria Benedetta} and Chiara Donfrancesco and Rossana Borchini and B{\"o}rschel, {Christin Susanna} and Simona Giampaoli and {Di Castelnuovo}, Augusto and Christina Magnussen and Frank Kee and Wolfgang Koenig and Stefan Blankenberg and {de Gaetano}, Giovanni and Hugh Tunstall-Pedoe and Susanne Rospleszcz and Torben J{\o}rgensen and Tanja Zeller and Kari Kuulasmaa and Allan Linneberg and Veikko Salomaa and Licia Iacoviello and Schnabel, {Renate B} and {BiomarCaRE Consortium}",
year = "2020",
month = "9",
doi = "10.1161/STROKEAHA.120.029452",
language = "English",
volume = "51",
pages = "2770--2777",
journal = "Journal of Stroke",
issn = "0039-2499",
publisher = "Lippincott Williams & Wilkins",
number = "9",

}

RIS

TY - JOUR

T1 - Cardiac Troponin I and Incident Stroke in European Cohorts

T2 - Insights From the BiomarCaRE Project

AU - Camen, Stephan

AU - Palosaari, Tarja

AU - Reinikainen, Jaakko

AU - Sprünker, Ngoc Anh

AU - Niiranen, Teemu

AU - Gianfagna, Francesco

AU - Vishram-Nielsen, Julie K K

AU - Costanzo, Simona

AU - Söderberg, Stefan

AU - Palmieri, Luigi

AU - Ferrario, Marco

AU - Peters, Annette

AU - Vartiainen, Erkki

AU - Donati, Maria Benedetta

AU - Donfrancesco, Chiara

AU - Borchini, Rossana

AU - Börschel, Christin Susanna

AU - Giampaoli, Simona

AU - Di Castelnuovo, Augusto

AU - Magnussen, Christina

AU - Kee, Frank

AU - Koenig, Wolfgang

AU - Blankenberg, Stefan

AU - de Gaetano, Giovanni

AU - Tunstall-Pedoe, Hugh

AU - Rospleszcz, Susanne

AU - Jørgensen, Torben

AU - Zeller, Tanja

AU - Kuulasmaa, Kari

AU - Linneberg, Allan

AU - Salomaa, Veikko

AU - Iacoviello, Licia

AU - Schnabel, Renate B

AU - BiomarCaRE Consortium

PY - 2020/9

Y1 - 2020/9

N2 - BACKGROUND AND PURPOSE: Stroke is a common cause of death and a leading cause of disability and morbidity. Stroke risk assessment remains a challenge, but circulating biomarkers may improve risk prediction. Controversial evidence is available on the predictive ability of troponin concentrations and the risk of stroke in the community. Furthermore, reports on the predictive value of troponin concentrations for different stroke subtypes are scarce.METHODS: High-sensitivity cardiac troponin I (hsTnI) concentrations were assessed in 82 881 individuals (median age, 50.7 years; 49.7% men) free of stroke or myocardial infarction at baseline from 9 prospective European community cohorts. We used Cox proportional hazards regression to determine relative risks, followed by measures of discrimination and reclassification using 10-fold cross-validation to control for overoptimism. Follow-up was based upon linkage with national hospitalization registries and causes of death registries.RESULTS: Over a median follow-up of 12.7 years, 3033 individuals were diagnosed with incident nonfatal or fatal stroke (n=1654 ischemic strokes, n=612 hemorrhagic strokes, and n=767 indeterminate strokes). In multivariable regression models, hsTnI concentrations were associated with overall stroke (hazard ratio per 1-SD increase, 1.15 [95% CI, 1.10-1.21]), ischemic stroke (hazard ratio, 1.14 [95% CI, 1.09-1.21]), and hemorrhagic stroke (hazard ratio, 1.10 [95% CI, 1.01-1.20]). Adding hsTnI concentrations to classical cardiovascular risk factors (C indices, 0.809, 0.840, and 0.736 for overall, ischemic, and hemorrhagic stroke, respectively) increased the C index significantly but modestly. In individuals with an intermediate 10-year risk (5%-20%), the net reclassification improvement for overall stroke was 0.038 (P=0.021).CONCLUSIONS: Elevated hsTnI concentrations are associated with an increased risk of incident stroke in the community, irrespective of stroke subtype. Adding hsTnI concentrations to classical risk factors only modestly improved estimation of 10-year risk of stroke in the overall cohort but might be of some value in individuals at an intermediate risk.

AB - BACKGROUND AND PURPOSE: Stroke is a common cause of death and a leading cause of disability and morbidity. Stroke risk assessment remains a challenge, but circulating biomarkers may improve risk prediction. Controversial evidence is available on the predictive ability of troponin concentrations and the risk of stroke in the community. Furthermore, reports on the predictive value of troponin concentrations for different stroke subtypes are scarce.METHODS: High-sensitivity cardiac troponin I (hsTnI) concentrations were assessed in 82 881 individuals (median age, 50.7 years; 49.7% men) free of stroke or myocardial infarction at baseline from 9 prospective European community cohorts. We used Cox proportional hazards regression to determine relative risks, followed by measures of discrimination and reclassification using 10-fold cross-validation to control for overoptimism. Follow-up was based upon linkage with national hospitalization registries and causes of death registries.RESULTS: Over a median follow-up of 12.7 years, 3033 individuals were diagnosed with incident nonfatal or fatal stroke (n=1654 ischemic strokes, n=612 hemorrhagic strokes, and n=767 indeterminate strokes). In multivariable regression models, hsTnI concentrations were associated with overall stroke (hazard ratio per 1-SD increase, 1.15 [95% CI, 1.10-1.21]), ischemic stroke (hazard ratio, 1.14 [95% CI, 1.09-1.21]), and hemorrhagic stroke (hazard ratio, 1.10 [95% CI, 1.01-1.20]). Adding hsTnI concentrations to classical cardiovascular risk factors (C indices, 0.809, 0.840, and 0.736 for overall, ischemic, and hemorrhagic stroke, respectively) increased the C index significantly but modestly. In individuals with an intermediate 10-year risk (5%-20%), the net reclassification improvement for overall stroke was 0.038 (P=0.021).CONCLUSIONS: Elevated hsTnI concentrations are associated with an increased risk of incident stroke in the community, irrespective of stroke subtype. Adding hsTnI concentrations to classical risk factors only modestly improved estimation of 10-year risk of stroke in the overall cohort but might be of some value in individuals at an intermediate risk.

U2 - 10.1161/STROKEAHA.120.029452

DO - 10.1161/STROKEAHA.120.029452

M3 - Journal article

VL - 51

SP - 2770

EP - 2777

JO - Journal of Stroke

JF - Journal of Stroke

SN - 0039-2499

IS - 9

ER -

ID: 60728090