Trajectories of cardiac troponin in the decades before cardiovascular death: a longitudinal cohort study.
Trajectories of cardiac troponin in the decades before cardiovascular death: a longitudinal cohort study.
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DOI：
10.1186/s12916-023-02921-8
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发表时间：
2023-06-19
期刊：
影响因子：
9.3
通讯作者：
Mills NL
中科院分区：
文献类型：
--
作者：
Kimenai DM;Anand A;de Bakker M;Shipley M;Fujisawa T;Lyngbakken MN;Hveem K;Omland T;Valencia-Hernández CA;Lindbohm JV;Kivimaki M;Singh-Manoux A;Strachan FE;Shah ASV;Kardys I;Boersma E;Brunner EJ;Mills NL
高灵敏度心肌肌钙蛋白检测是一种很有前途的心血管风险预测工具，但系列检测能否动态预测风险尚不确定。我们评估了一般人群心血管事件发生前几年心肌肌钙蛋白I的变化轨迹，并确定连续测量是否可以跟踪个体内的风险。在白厅II队列中，在15年的时间内三次测量高灵敏度心肌肌钙蛋白I浓度。在随访期间，与存活或死于其他原因的受试者相比，在死于心血管疾病的受试者中构建了肌钙蛋白的时间轨迹，并在HUNT研究中进行了外部验证。采用一种调整心血管危险因素的联合模型，通过连续肌钙蛋白测量来估计心血管死亡风险。在7，293例受试者（平均58 ± 7年，29.4%为女性）中，分别有281例（3.9%）和914例（12.5%）受试者发生心血管和非心血管死亡（中位随访时间为21.4年）。在Whitehall和HUNT中，与存活或死于其他原因的患者相比，死于心血管疾病的患者的肌钙蛋白浓度增加的轨迹更陡（两者的P相互作用< 0.05）。联合模型显示肌钙蛋白的时间演变与心血管死亡风险之间存在独立相关性（HR/倍增，1.45，95%CI，1.33 -1.75）。在过去的几十年里，与那些幸存或死于其他原因的人相比，死于心血管疾病的人的心肌肌钙蛋白I浓度增加。在普通人群中进行系列心肌肌钙蛋白检测有可能跟踪未来的心血管风险。 在线版本包含补充材料，可通过10.1186/s12916-023-02921-8获得。
High-sensitivity cardiac troponin testing is a promising tool for cardiovascular risk prediction, but whether serial testing can dynamically predict risk is uncertain. We evaluated the trajectory of cardiac troponin I in the years prior to a cardiovascular event in the general population, and determine whether serial measurements could track risk within individuals. In the Whitehall II cohort, high-sensitivity cardiac troponin I concentrations were measured on three occasions over a 15-year period. Time trajectories of troponin were constructed in those who died from cardiovascular disease compared to those who survived or died from other causes during follow up and these were externally validated in the HUNT Study. A joint model that adjusts for cardiovascular risk factors was used to estimate risk of cardiovascular death using serial troponin measurements. In 7,293 individuals (mean 58 ± 7 years, 29.4% women) cardiovascular and non-cardiovascular death occurred in 281 (3.9%) and 914 (12.5%) individuals (median follow-up 21.4 years), respectively. Troponin concentrations increased in those dying from cardiovascular disease with a steeper trajectory compared to those surviving or dying from other causes in Whitehall and HUNT (Pinteraction < 0.05 for both). The joint model demonstrated an independent association between temporal evolution of troponin and risk of cardiovascular death (HR per doubling, 1.45, 95% CI,1.33–1.75). Cardiac troponin I concentrations increased in those dying from cardiovascular disease compared to those surviving or dying from other causes over the preceding decades. Serial cardiac troponin testing in the general population has potential to track future cardiovascular risk. The online version contains supplementary material available at 10.1186/s12916-023-02921-8.
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影响因子：
24
作者：
McEvoy, John W.;Chen, Yuan;Selvin, Elizabeth
通讯作者：
Selvin, Elizabeth
影响因子：
9.3
作者：
Lyngbakken, Magnus N.;Rosjo, Helge;Omland, Torbjorn
通讯作者：
Omland, Torbjorn
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影响因子：
4.8
作者：
Daniels LB;Clopton P;deFilippi CR;Sanchez OA;Bahrami H;Lima JA;Tracy RP;Siscovick D;Bertoni AG;Greenland P;Cushman M;Maisel AS;Criqui MH
通讯作者：
Criqui MH
影响因子：
39.3
作者：
Blankenberg S;Salomaa V;Makarova N;Ojeda F;Wild P;Lackner KJ;Jørgensen T;Thorand B;Peters A;Nauck M;Petersmann A;Vartiainen E;Veronesi G;Brambilla P;Costanzo S;Iacoviello L;Linden G;Yarnell J;Patterson CC;Everett BM;Ridker PM;Kontto J;Schnabel RB;Koenig W;Kee F;Zeller T;Kuulasmaa K;BiomarCaRE Investigators
通讯作者：
BiomarCaRE Investigators
影响因子：
24
作者：
Berry, Jarett D.;Nambi, Vijay;de Lemos, James A.
通讯作者：
de Lemos, James A.