Temporal Changes in Cardiac Troponin I Are Associated with Risk of Cardiovascular Events in the General Population: The Nord-Trondelag Health Study
Temporal Changes in Cardiac Troponin I Are Associated with Risk of Cardiovascular Events in the General Population: The Nord-Trondelag Health Study
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DOI：
10.1373/clinchem.2018.301069
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发表时间：
2019-07-01
影响因子：
9.3
通讯作者：
Omland, Torbjorn
中科院分区：
文献类型：
--
作者：
Lyngbakken, Magnus N.;Rosjo, Helge;Omland, Torbjorn
背景技术背景：在一般人群中，心肌肌钙蛋白与心血管风险相关，但心肌肌钙蛋白I的时间变化是否提供独立的预后信息仍不确定。我们使用一个大型的社区队列，随访时间接近现在，目的是研究心肌肌钙蛋白的时间变化与心血管事件之间的关系。方法：我们在4805名参加第二次和第三次心脏检查的参与者中，用高灵敏度测定法（hs-cTnI）测量了心肌肌钙蛋白I。（HUNT 2，1995-97）和第三波（HUNT 3，2006-2008）前瞻性观察性Nord-Trondelag健康（HUNT）研究。我们构建了hs-cTnI从HUNT 2到HUNT 3的相对和绝对变化的统计模型。复合终点心血管死亡或首次入院心肌梗死或心力衰竭produced.RESULTS：参与者与相对降低hs-cTnI更频繁地年轻和女性，有较低的血压和体重指数。hs-cTnI相对增加的参与者更常见于年龄较大的男性，收缩压较高。hs-cTnI相对升高的校正风险比（HR）为1.68（95% CI，1.16-2.42），相对降低的校正HR为1.19（95% CI，0.84-1.68）。hs-cTnI的绝对升高显示出与hs-cTnI相对升高相似的预后特性。最近的测量hs-cTnI优于歧视和重新分类models.CONCLUSIONS：相对和绝对增加hs-cTnI的变化变量与心血管疾病的风险独立相关。为了完善风险预测模型，在临床实践中应首选最新的hs-cTnI测量。(C)2019年美国临床化学协会
BACKGROUND: Cardiac troponins are associated with cardiovascular risk in the general population, but whether temporal changes in cardiac troponin I provide independent prognostic information remains uncertain. Using a large community-based cohort with follow-up close to the present day, we aimed to investigate the associations between temporal changes in cardiac troponin and cardiovascular events.METHODS: We measured cardiac troponin I with a high-sensitivity assay (hs-cTnI) in 4805 participants attending both the second (HUNT 2, 1995-97) and third wave (HUNT 3, 2006-2008) of the prospective observational Nord-Trondelag Health (HUNT) Study. We constructed statistical models with both relative and absolute changes of hs-cTnI from HUNT 2 to HUNT 3. A composite end point of cardiovascular death or first admission for myocardial infarction or heart failure was generated.RESULTS: Participants with relative decrease in hs-cTnI were more frequently younger and female and had lower blood pressure and body mass index. Participants with relative increase in hs-cTnI more frequently were older and male, with higher systolic blood pressure. The adjusted hazard ratio (HR) for relative increase in hs-cTnI was 1.68 (95% CI, 1.16-2.42) and the adjusted HR for relative decrease was 1.19 (95% CI, 0.84-1.68). Absolute increases in hs-cTnI exhibited similar prognostic properties as relative increases in hs-cTnI. The most recent measurement of hs-cTnI outperformed the change variables in discrimination and reclassification models.CONCLUSIONS: Both relative and absolute increases in hs-cTnI are independently associated with cardiovascular risk. For refinement of risk prediction models, the most recent measurement of hs-cTnI should be preferred in clinical practice. (C) 2019 American Association for Clinical Chemistry