Cardiac Troponin T Measured by a High-Sensitivity Assay Predicts Recurrent Cardiovascular Events in Stable Coronary Heart Disease Patients with 8-Year Follow-up
The clinical relevance of slightly increased circulating troponin concentrations in patients with stable coronary heart disease (CHD) several weeks after an acute event or CABG has not been fully evaluated. Baseline plasma concentrations of troponin T were measured with a high-sensitivity assay (hs-...
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| Veröffentlicht in: | Clinical chemistry (Baltimore, Md.) Md.), 2012-08, Vol.58 (8), p.1215-1224 |
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| container_title | Clinical chemistry (Baltimore, Md.) |
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| creator | KOENIG, Wolfgang BREITLING, Lutz P HAHMANN, Harry WÜSTEN, Bernd BRENNER, Hermann ROTHENBACHER, Dietrich |
| description | The clinical relevance of slightly increased circulating troponin concentrations in patients with stable coronary heart disease (CHD) several weeks after an acute event or CABG has not been fully evaluated.
Baseline plasma concentrations of troponin T were measured with a high-sensitivity assay (hs-cTnT) (Roche Elecsys) in a cohort of 1050 CHD patients from 30 to 70 years of age. The prognostic value of hs-cTnT on a combined cardiovascular disease (CVD) end point after adjustment for covariates was determined with Cox proportional hazards modeling.
The median hs-cTnT concentration was 10.9 ng/L (interquartile range, 5.1-18.9 ng/L). Increased hs-cTnT concentrations were associated with an older age, history of hypertension and diabetes, more advanced coronary artery disease, and other CHD risk factors. Furthermore, hs-cTnT concentration was strongly correlated with N-terminal pro-B-type natriuretic peptide (NT-proBNP) and cystatin C (ρ = 0.61, and ρ = 0.32, respectively; both P values |
| doi_str_mv | 10.1373/clinchem.2012.183319 |
| format | Article |
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Baseline plasma concentrations of troponin T were measured with a high-sensitivity assay (hs-cTnT) (Roche Elecsys) in a cohort of 1050 CHD patients from 30 to 70 years of age. The prognostic value of hs-cTnT on a combined cardiovascular disease (CVD) end point after adjustment for covariates was determined with Cox proportional hazards modeling.
The median hs-cTnT concentration was 10.9 ng/L (interquartile range, 5.1-18.9 ng/L). Increased hs-cTnT concentrations were associated with an older age, history of hypertension and diabetes, more advanced coronary artery disease, and other CHD risk factors. Furthermore, hs-cTnT concentration was strongly correlated with N-terminal pro-B-type natriuretic peptide (NT-proBNP) and cystatin C (ρ = 0.61, and ρ = 0.32, respectively; both P values <0.0001). During a median follow-up of 8.1 years, 150 patients (14.3%) experienced a secondary CVD event. In a multivariate model, hs-cTnT was associated with a hazard ratio (HR) for secondary events of 2.83 (95% CI, 1.68-4.79) when the extreme quartiles were compared. Further adjustment for cystatin C, NT-proBNP, and C-reactive protein attenuated this association only slightly (HR, 2.27; 95% CI, 1.31-3.95); P for trend < 0.002). ROC curve analysis of a clinical model that added hs-cTnT to a baseline model showed nonsignificant improvement in the area under the curve (0.69 vs 0.67), whereas the net reclassification improvement was 17.2% (P = 0.029).
Slightly increased hs-cTnT concentrations in stable CHD patients are associated with several cardiovascular disorders and predict long-term CVD events.</description><identifier>ISSN: 0009-9147</identifier><identifier>EISSN: 1530-8561</identifier><identifier>DOI: 10.1373/clinchem.2012.183319</identifier><identifier>PMID: 22634379</identifier><identifier>CODEN: CLCHAU</identifier><language>eng</language><publisher>Washington, DC: American Association for Clinical Chemistry</publisher><subject>1-Alkyl-2-acetylglycerophosphocholine Esterase - blood ; Acute coronary syndromes ; Adult ; Aged ; Analytical, structural and metabolic biochemistry ; Biological and medical sciences ; Biomarkers ; C-Reactive Protein - analysis ; Cardiovascular disease ; Cardiovascular diseases ; Confounding Factors (Epidemiology) ; Coronary Artery Bypass ; Coronary Disease - diagnosis ; Coronary Disease - surgery ; Cystatin C - blood ; Endpoint Determination ; Family medical history ; Female ; Follow-Up Studies ; Fundamental and applied biological sciences. Psychology ; Heart attacks ; Heart failure ; Hospitals ; Humans ; Hypertension ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical sciences ; Middle Aged ; Molecular biophysics ; Mortality ; Natriuretic Peptide, Brain - blood ; Peptide Fragments - blood ; Phospholipases A2, Secretory - blood ; Predictive Value of Tests ; Questionnaires ; Recurrence ; Rehabilitation ; Risk factors ; Troponin T - blood</subject><ispartof>Clinical chemistry (Baltimore, Md.), 2012-08, Vol.58 (8), p.1215-1224</ispartof><rights>2015 INIST-CNRS</rights><rights>Copyright American Association for Clinical Chemistry Aug 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-4cb1275e5f928adf0a0715b967ff49ad2215204c1c67526ef94da5c0f89d27963</citedby><cites>FETCH-LOGICAL-c411t-4cb1275e5f928adf0a0715b967ff49ad2215204c1c67526ef94da5c0f89d27963</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26184777$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22634379$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>KOENIG, Wolfgang</creatorcontrib><creatorcontrib>BREITLING, Lutz P</creatorcontrib><creatorcontrib>HAHMANN, Harry</creatorcontrib><creatorcontrib>WÜSTEN, Bernd</creatorcontrib><creatorcontrib>BRENNER, Hermann</creatorcontrib><creatorcontrib>ROTHENBACHER, Dietrich</creatorcontrib><title>Cardiac Troponin T Measured by a High-Sensitivity Assay Predicts Recurrent Cardiovascular Events in Stable Coronary Heart Disease Patients with 8-Year Follow-up</title><title>Clinical chemistry (Baltimore, Md.)</title><addtitle>Clin Chem</addtitle><description>The clinical relevance of slightly increased circulating troponin concentrations in patients with stable coronary heart disease (CHD) several weeks after an acute event or CABG has not been fully evaluated.
Baseline plasma concentrations of troponin T were measured with a high-sensitivity assay (hs-cTnT) (Roche Elecsys) in a cohort of 1050 CHD patients from 30 to 70 years of age. The prognostic value of hs-cTnT on a combined cardiovascular disease (CVD) end point after adjustment for covariates was determined with Cox proportional hazards modeling.
The median hs-cTnT concentration was 10.9 ng/L (interquartile range, 5.1-18.9 ng/L). Increased hs-cTnT concentrations were associated with an older age, history of hypertension and diabetes, more advanced coronary artery disease, and other CHD risk factors. Furthermore, hs-cTnT concentration was strongly correlated with N-terminal pro-B-type natriuretic peptide (NT-proBNP) and cystatin C (ρ = 0.61, and ρ = 0.32, respectively; both P values <0.0001). During a median follow-up of 8.1 years, 150 patients (14.3%) experienced a secondary CVD event. In a multivariate model, hs-cTnT was associated with a hazard ratio (HR) for secondary events of 2.83 (95% CI, 1.68-4.79) when the extreme quartiles were compared. Further adjustment for cystatin C, NT-proBNP, and C-reactive protein attenuated this association only slightly (HR, 2.27; 95% CI, 1.31-3.95); P for trend < 0.002). ROC curve analysis of a clinical model that added hs-cTnT to a baseline model showed nonsignificant improvement in the area under the curve (0.69 vs 0.67), whereas the net reclassification improvement was 17.2% (P = 0.029).
Slightly increased hs-cTnT concentrations in stable CHD patients are associated with several cardiovascular disorders and predict long-term CVD events.</description><subject>1-Alkyl-2-acetylglycerophosphocholine Esterase - blood</subject><subject>Acute coronary syndromes</subject><subject>Adult</subject><subject>Aged</subject><subject>Analytical, structural and metabolic biochemistry</subject><subject>Biological and medical sciences</subject><subject>Biomarkers</subject><subject>C-Reactive Protein - analysis</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular diseases</subject><subject>Confounding Factors (Epidemiology)</subject><subject>Coronary Artery Bypass</subject><subject>Coronary Disease - diagnosis</subject><subject>Coronary Disease - surgery</subject><subject>Cystatin C - blood</subject><subject>Endpoint Determination</subject><subject>Family medical history</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Heart attacks</subject><subject>Heart failure</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Molecular biophysics</subject><subject>Mortality</subject><subject>Natriuretic Peptide, Brain - blood</subject><subject>Peptide Fragments - blood</subject><subject>Phospholipases A2, Secretory - blood</subject><subject>Predictive Value of Tests</subject><subject>Questionnaires</subject><subject>Recurrence</subject><subject>Rehabilitation</subject><subject>Risk factors</subject><subject>Troponin T - blood</subject><issn>0009-9147</issn><issn>1530-8561</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNpdkd9uFCEUh4nR2LX6BsaQGBNvZuXwZxgum7XtmtTY2PXCqwnDgEszO6zAbLNv46OWdreaeEXgfOcHhw-ht0DmwCT7ZAY_mrXdzCkBOoeGMVDP0AwEI1UjaniOZoQQVSng8gS9Sum2bLls6pfohNKacSbVDP1Z6Nh7bfAqhm0Y_YhX-KvVaYq2x90ea7z0v9bVjR2Tz37n8x6fpaT3-LoA3uSEv1szxWjHjB-jwk4nMw064vNdOUy4RN5k3Q0WL0IMo457vLQ6ZvzZp3KRxdc6-0fyzuc1bqqfpYovwjCEu2ravkYvnB6SfXNcT9GPi_PVYlldfbv8sji7qgwHyBU3HVAprHCKNrp3RBMJolO1dI4r3VMKghJuwNRS0No6xXstDHGN6qlUNTtFHw-52xh-TzblduOTscOgRxum1AJhhAlgwAr6_j_0NkxxLK9rgfEGQAkOheIHysSQUrSu3Ua_KeOXqPbBYPtksH0w2B4MlrZ3x_Cp29j-b9OTsgJ8OALlo_Xgoh6NT_-4GhoupWT38l2m5w</recordid><startdate>20120801</startdate><enddate>20120801</enddate><creator>KOENIG, Wolfgang</creator><creator>BREITLING, Lutz P</creator><creator>HAHMANN, Harry</creator><creator>WÜSTEN, Bernd</creator><creator>BRENNER, Hermann</creator><creator>ROTHENBACHER, Dietrich</creator><general>American Association for Clinical Chemistry</general><general>Oxford University Press</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4U-</scope><scope>7QO</scope><scope>7RV</scope><scope>7TM</scope><scope>7U7</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>BKSAR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PCBAR</scope><scope>PDBOC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>RC3</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>20120801</creationdate><title>Cardiac Troponin T Measured by a High-Sensitivity Assay Predicts Recurrent Cardiovascular Events in Stable Coronary Heart Disease Patients with 8-Year Follow-up</title><author>KOENIG, Wolfgang ; BREITLING, Lutz P ; HAHMANN, Harry ; WÜSTEN, Bernd ; BRENNER, Hermann ; ROTHENBACHER, Dietrich</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-4cb1275e5f928adf0a0715b967ff49ad2215204c1c67526ef94da5c0f89d27963</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>1-Alkyl-2-acetylglycerophosphocholine Esterase - blood</topic><topic>Acute coronary syndromes</topic><topic>Adult</topic><topic>Aged</topic><topic>Analytical, structural and metabolic biochemistry</topic><topic>Biological and medical sciences</topic><topic>Biomarkers</topic><topic>C-Reactive Protein - analysis</topic><topic>Cardiovascular disease</topic><topic>Cardiovascular diseases</topic><topic>Confounding Factors (Epidemiology)</topic><topic>Coronary Artery Bypass</topic><topic>Coronary Disease - diagnosis</topic><topic>Coronary Disease - surgery</topic><topic>Cystatin C - blood</topic><topic>Endpoint Determination</topic><topic>Family medical history</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Heart attacks</topic><topic>Heart failure</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Molecular biophysics</topic><topic>Mortality</topic><topic>Natriuretic Peptide, Brain - blood</topic><topic>Peptide Fragments - blood</topic><topic>Phospholipases A2, Secretory - blood</topic><topic>Predictive Value of Tests</topic><topic>Questionnaires</topic><topic>Recurrence</topic><topic>Rehabilitation</topic><topic>Risk factors</topic><topic>Troponin T - blood</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>KOENIG, Wolfgang</creatorcontrib><creatorcontrib>BREITLING, Lutz P</creatorcontrib><creatorcontrib>HAHMANN, Harry</creatorcontrib><creatorcontrib>WÜSTEN, Bernd</creatorcontrib><creatorcontrib>BRENNER, Hermann</creatorcontrib><creatorcontrib>ROTHENBACHER, Dietrich</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>University Readers</collection><collection>Biotechnology Research Abstracts</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Nucleic Acids Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Earth, Atmospheric & Aquatic Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Earth, Atmospheric & Aquatic Science Database</collection><collection>Materials Science Collection</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>Genetics Abstracts</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical chemistry (Baltimore, Md.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>KOENIG, Wolfgang</au><au>BREITLING, Lutz P</au><au>HAHMANN, Harry</au><au>WÜSTEN, Bernd</au><au>BRENNER, Hermann</au><au>ROTHENBACHER, Dietrich</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cardiac Troponin T Measured by a High-Sensitivity Assay Predicts Recurrent Cardiovascular Events in Stable Coronary Heart Disease Patients with 8-Year Follow-up</atitle><jtitle>Clinical chemistry (Baltimore, Md.)</jtitle><addtitle>Clin Chem</addtitle><date>2012-08-01</date><risdate>2012</risdate><volume>58</volume><issue>8</issue><spage>1215</spage><epage>1224</epage><pages>1215-1224</pages><issn>0009-9147</issn><eissn>1530-8561</eissn><coden>CLCHAU</coden><abstract>The clinical relevance of slightly increased circulating troponin concentrations in patients with stable coronary heart disease (CHD) several weeks after an acute event or CABG has not been fully evaluated.
Baseline plasma concentrations of troponin T were measured with a high-sensitivity assay (hs-cTnT) (Roche Elecsys) in a cohort of 1050 CHD patients from 30 to 70 years of age. The prognostic value of hs-cTnT on a combined cardiovascular disease (CVD) end point after adjustment for covariates was determined with Cox proportional hazards modeling.
The median hs-cTnT concentration was 10.9 ng/L (interquartile range, 5.1-18.9 ng/L). Increased hs-cTnT concentrations were associated with an older age, history of hypertension and diabetes, more advanced coronary artery disease, and other CHD risk factors. Furthermore, hs-cTnT concentration was strongly correlated with N-terminal pro-B-type natriuretic peptide (NT-proBNP) and cystatin C (ρ = 0.61, and ρ = 0.32, respectively; both P values <0.0001). During a median follow-up of 8.1 years, 150 patients (14.3%) experienced a secondary CVD event. In a multivariate model, hs-cTnT was associated with a hazard ratio (HR) for secondary events of 2.83 (95% CI, 1.68-4.79) when the extreme quartiles were compared. Further adjustment for cystatin C, NT-proBNP, and C-reactive protein attenuated this association only slightly (HR, 2.27; 95% CI, 1.31-3.95); P for trend < 0.002). ROC curve analysis of a clinical model that added hs-cTnT to a baseline model showed nonsignificant improvement in the area under the curve (0.69 vs 0.67), whereas the net reclassification improvement was 17.2% (P = 0.029).
Slightly increased hs-cTnT concentrations in stable CHD patients are associated with several cardiovascular disorders and predict long-term CVD events.</abstract><cop>Washington, DC</cop><pub>American Association for Clinical Chemistry</pub><pmid>22634379</pmid><doi>10.1373/clinchem.2012.183319</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | 1-Alkyl-2-acetylglycerophosphocholine Esterase - blood Acute coronary syndromes Adult Aged Analytical, structural and metabolic biochemistry Biological and medical sciences Biomarkers C-Reactive Protein - analysis Cardiovascular disease Cardiovascular diseases Confounding Factors (Epidemiology) Coronary Artery Bypass Coronary Disease - diagnosis Coronary Disease - surgery Cystatin C - blood Endpoint Determination Family medical history Female Follow-Up Studies Fundamental and applied biological sciences. Psychology Heart attacks Heart failure Hospitals Humans Hypertension Investigative techniques, diagnostic techniques (general aspects) Male Medical sciences Middle Aged Molecular biophysics Mortality Natriuretic Peptide, Brain - blood Peptide Fragments - blood Phospholipases A2, Secretory - blood Predictive Value of Tests Questionnaires Recurrence Rehabilitation Risk factors Troponin T - blood |
| title | Cardiac Troponin T Measured by a High-Sensitivity Assay Predicts Recurrent Cardiovascular Events in Stable Coronary Heart Disease Patients with 8-Year Follow-up |
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