Association of Repeatedly Measured High-Sensitivity-Assayed Troponin I with Cardiovascular Disease Events in a General Population from the MORGAM/BiomarCaRE Study
| Autor: | Francisco Ojeda, Olli Saarela, Tarja Palosaari, Kari Kuulasmaa, Torben Jørgensen, Maria Hughes, Stefan Blankenberg, Anders Borglykke, Frank Kee, Tanja Zeller, Mark G. O'Doherty |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Clinical Biochemistry Population macromolecular substances 030204 cardiovascular system & hematology Cohort Studies 03 medical and health sciences 0302 clinical medicine SDG 3 - Good Health and Well-being Interquartile range Internal medicine Troponin I medicine Humans Prospective Studies cardiovascular diseases 030212 general & internal medicine education Prospective cohort study education.field_of_study business.industry Proportional hazards model Biochemistry (medical) Hazard ratio Repeated measures design Middle Aged musculoskeletal system Surgery Cardiovascular Diseases cardiovascular system Cardiology Female business Biomarkers Cohort study |
| Zdroj: | Hughes, M F, Ojeda, F, Saarela, O, Jørgensen, T, Zeller, T, Palosaari, T, O'Doherty, M G, Borglykke, A, Kuulasmaa, K, Blankenberg, S & Kee, F 2017, ' Association of Repeatedly Measured High-Sensitivity-Assayed Troponin I with Cardiovascular Disease Events in a General Population from the MORGAM/BiomarCaRE Study ', Clinical Chemistry, vol. 63, no. 1, pp. 334-342 . https://doi.org/10.1373/clinchem.2016.261172 |
| Popis: | BACKGROUND High-sensitivity troponin I (hs-cTnI) concentrations reflect myocardial stress. The role of hs-cTnI in predicting long-term changes in the risk of cardiovascular disease (CVD) in general populations is not clearly defined. METHODS We investigated whether the change in 3 repeated measures of hs-cTnI collected 5 years apart in a prospective Danish study (3875 participants, initially aged 30–60 years, 51% female, disease free at baseline) improves 10-year prediction of incident CVD compared to using a single most recent hs-cTnI measurement. The change process was modelled using a joint (longitudinal and survival) model and compared to a Cox model using a single hs-cTnI measure adjusted for classic CVD risk factors, and evaluated using discrimination statistics. RESULTS Median hs-cTnI concentrations changed from 2.6 ng/L to 3.4 ng/L over 10 years. The change in hs-cTnI predicts 10-year risk of CVD (581 events); the joint model gave a hazard ratio of 1.31 per interquartile difference in hs-cTnI (95% CI 1.15–1.48) after adjustment for CVD risk factors. However, the joint model performed only marginally better (c-index improvement 0.0041, P = 0.03) than using a single hs-cTnI measure (c-index improvement 0.0052, P = 0.04) for prediction of CVD, compared to a model incorporating CVD risk factors without hs-cTnI (c-index 0.744). CONCLUSIONS The change in hs-cTnI in 5-year intervals better predicts risk of CVD in the general population, but the most recent measure of hs-cTnI, (at 10 years) is as effective in predicting CVD risk. This simplifies the use of hs-cTnI as a prognostic marker for primary prevention of CVD in the general population. |
| Databáze: | OpenAIRE |
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