Associations of High-Sensitivity Troponin and Natriuretic Peptide Levels With Outcomes After Intensive Blood Pressure Lowering Findings From the SPRINT Randomized Clinical Trial
Associations of High-Sensitivity Troponin and Natriuretic Peptide Levels With Outcomes After Intensive Blood Pressure Lowering Findings From the SPRINT Randomized Clinical Trial
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DOI：
10.1001/jamacardio.2021.3187
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发表时间：
2021-09-01
期刊：
影响因子：
24
通讯作者：
de Lemos, James A.
中科院分区：
文献类型：
--
作者：
Berry, Jarett D.;Nambi, Vijay;de Lemos, James A.
在普通人群中，高敏心肌肌钙蛋白T（hscTnT）和N末端B型利钠肽原（NTproBNP）水平升高与心力衰竭（HF）风险和死亡率相关。目的：为了检验hscTnT和NTproBNP水平升高将识别具有最大死亡率和HF风险以及与强化收缩压（SBP）降低相关的最大益处的个体的假设。随机临床收缩压干预试验（SPRINT），于2010年10月20日至2015年8月20日进行。共有9361例心血管疾病风险增加的非糖尿病患者随机接受强化与标准SBP降低治疗。从2019年9月30日至2021年7月29日，在意向治疗的基础上进行统计分析。
IMPORTANCE Elevated high-sensitivity cardiac troponin T (hscTnT) and N-terminal pro-B-type natriuretic peptide (NTproBNP) levels are associated with risk of heart failure (HF) and mortality among individuals in the general population. However, it is unknown if this risk is modifiable.OBJECTIVE To test the hypothesis that elevated hscTnT and NTproBNP levels would identify individuals with the greatest risk for mortality and HF and the largest benefit associated with intensive systolic blood pressure (SBP) lowering.DESIGN, SETTING, AND PARTICIPANTS This is a nonprespecified post hoc analysis of the multicenter, prospective, randomized clinical Systolic Blood Pressure Intervention Trial (SPRINT), conducted from October 20, 2010, to August 20, 2015. A total of 9361 patients without diabetes with increased risk for cardiovascular disease were randomized to receive intensive vs standard SBP lowering. Statistical analysis was performed on an intention-to-treat basis from September 30, 2019, to July 29, 2021.INTERVENTIONS Participants were randomized to undergo intensive (