High-Sensitivity Cardiac Troponins I and T and Cardiovascular Outcomes: Findings from the Systolic Blood Pressure Intervention Trial (SPRINT).
High-Sensitivity Cardiac Troponins I and T and Cardiovascular Outcomes: Findings from the Systolic Blood Pressure Intervention Trial (SPRINT).
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高敏心肌肌钙蛋白 I 和 T 与心血管结果：收缩压干预试验 (SPRINT) 的结果。
DOI：
10.1093/clinchem/hvad209
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发表时间：
2024
影响因子：
9.3
通讯作者：
Ballantyne,ChristieM
中科院分区：
文献类型：
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作者：
Jia,Xiaoming;Nambi,Vijay;Berry,JarettD;Dalmacy,Djhenne;Ascher,SimonB;Taylor,AddisonA;Hoogeveen,RonC;deLemos,JamesA;Ballantyne,ChristieM
背景心肌肌钙蛋白与心血管疾病（CVD）的不良结局相关。高敏感性心肌肌钙蛋白I（hs-cTnI）的价值独立和音乐会与肌钙蛋白T（hs-cTnT）在高血压的管理还没有得到很好的study.MethodsWe评估的效用hs-cTnI独立和hs-cTnT在确定最高风险的个人在收缩期血压干预试验（SPRINT）。在8796名合格的SPRINT参与者中，在基线和1年时测量了hs-cTnI。使用校正的考克斯回归模型评价基线水平和1年hs-cTnI变化与CVD事件和全因死亡的相关性。我们进一步评估了hs-cTnI和hs-cTnT的互补价值，通过确定一致和不一致的类别，并评估其与outcome. Results-cTnI呈正相关的复合心血管疾病风险[心肌梗死，其他急性冠脉综合征，中风，或心血管死亡：风险比1.23，95%置信区间1.08-1.39/log（肌钙蛋白I）增加1个单位]，独立于传统风险因素、N末端B型利钠肽前体和hs-cTnT。在基线hs-cTnI较高（男性≥6 ng/L，女性≥4 ng/L）的患者中，强化降压与CVD事件的绝对风险降低幅度更大（4.5% vs 1.7%）和需要治疗的人数更少（23 vs 59）相关。 1年时hs-cTnI升高也与CVD风险增加相关。高敏肌钙蛋白I和高敏肌钙蛋白T是互补的，并在这两个确定的个人的心血管疾病和death.ConclusionsBaseline水平和高敏肌钙蛋白I的变化超过1年的风险最高的个人可能会获得更大的心血管疾病的好处与强化血压治疗。hs-TnI和hs-TnT在CVD风险中具有互补价值。assessment.ClinicalTrials.gov
BackgroundCardiac troponins are associated with adverse cardiovascular disease (CVD) outcomes. The value of high-sensitivity cardiac troponin I (hs-cTnI) independently and in concert with troponin T (hs-cTnT) in the management of hypertension has not been well studied.MethodsWe assessed the utility of hs-cTnI independently and with hs-cTnT in identifying the highest risk individuals in the Systolic Blood Pressure Intervention Trial (SPRINT). Among 8796 eligible SPRINT participants, hs-cTnI was measured at baseline and 1 year. The association of baseline level and 1-year change in hs-cTnI with CVD events and all-cause death was evaluated using adjusted Cox regression models. We further assessed the complementary value of hs-cTnI and hs-cTnT by identifying concordant and discordant categories and assessing their association with outcomes.Resultshs-cTnI was positively associated with composite CVD risk [myocardial infarction, other acute coronary syndrome, stroke, or cardiovascular death: hazard ratio 1.23, 95% confidence interval 1.08–1.39 per 1-unit increase in log(troponin I)] independent of traditional risk factors, N-terminal pro-B-type natriuretic peptide, and hs-cTnT. Intensive blood pressure lowering was associated with greater absolute risk reduction (4.5% vs 1.7%) and lower number needed to treat (23 vs 59) for CVD events among those with higher baseline hs-cTnI (≥6 ng/L in men, ≥4 ng/L in women). hs-cTnI increase at 1 year was also associated with increased CVD risk. hs-cTnI and hs-cTnT were complementary, and elevations in both identified individuals with the highest risk for CVD and death.ConclusionsBaseline levels and change in hs-cTnI over 1 year identified higher-risk individuals who may derive greater cardiovascular benefit with intensive blood pressure treatment. hs-TnI and hs-TnT have complementary value in CVD risk assessment.ClinicalTrials.gov Registration Number: NCT01206062.