Combined use of high-sensitivity cardiac troponin T and N-terminal pro-B type natriuretic peptide improves measurements of performance over established mortality risk factors in chronic heart failure

2012 ◽  
Vol 163 (5) ◽  
pp. 821-828 ◽  
Author(s):  
Marta de Antonio ◽  
Josep Lupon ◽  
Amparo Galan ◽  
Joan Vila ◽  
Agustin Urrutia ◽  
...  
Author(s):  
Kristian Berge ◽  
Magnus Nakrem Lyngbakken ◽  
Peder Langeland Myhre ◽  
Jon Brynildsen ◽  
Ragnhild Røysland ◽  
...  

2015 ◽  
Vol 61 (12) ◽  
pp. 1524-1531 ◽  
Author(s):  
Ravi H Parikh ◽  
Stephen L Seliger ◽  
James de Lemos ◽  
Vijay Nambi ◽  
Robert Christenson ◽  
...  

Abstract BACKGROUND There is controversy regarding whether to report concentrations of high-sensitivity cardiac troponin T (hs-cTnT) to the limit of blank (LOB) (3 ng/L) or the limit of detection (LOD) (5 ng/L) of the assay in community-based cohorts. We hypothesized that hs-cTnT concentrations between the LOB and LOD would be associated with poorer cardiovascular outcomes compared to concentrations below the LOB. METHODS hs-cTnT was analyzed in a total of 10 723 participants from the Cardiovascular Health Study (CHS), Atherosclerosis Risk in Communities (ARIC) study, and Dallas Heart Study (DHS). Participants were divided into 2 groups, those with hs-cTnT concentrations below the limit of blank (LOB) (<3 ng/L) and those with hs-cTnT between the LOB and limit of detection (LOD) (3–4.99 ng/L). Cross-sectional associations with traditional cardiovascular risk factors and cardiac structural measurements, and longitudinal associations with long-term cardiovascular outcomes of incident heart failure and cardiovascular death, were determined. RESULTS Participants with hs-cTnT between the LOB and LOD for all 3 cohorts were older, more likely to be male, and have a higher burden of cardiovascular risk factors and structural pathology. A metaanalysis of the 3 cohorts showed participants with hs-cTnT between the LOB and LOD were at increased risk of new-onset heart failure (hazard ratio, 1.18; 95% CI, 1.02–1.38) and cardiovascular mortality (hazard ratio, 1.29; 95% CI, 1.06–1.57). CONCLUSIONS hs-cTnT concentrations between the LOB and LOD (3–4.99 ng/L) are associated with a higher prevalence of traditional risk factors, more cardiac pathology, and worse outcomes than concentrations below the LOB (<3 ng/L).


Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Pratyaksh K Srivastava ◽  
Aruna D Pradhan ◽  
Nancy R Cook ◽  
Paul M Ridker ◽  
Brendan M Everett

Introduction: Alcohol use, physical activity, diet, and cigarette smoking are modifiable cardiovascular risk factors that have a substantial impact on the risk of myocardial infarction, stroke, and cardiovascular death. Hypothesis: We hypothesized that these behaviors may alter concentrations of cardiac troponin, a marker of myocyte injury, and B-type natriuretic peptide, a marker of myocyte stress. Both markers have shown strong association with adverse cardiovascular outcomes. Methods: In 564 women with no evidence of cardiovascular disease, we measured circulating concentrations of cardiac troponin T, measured using a high-sensitivity assay (hsTnT), and the N-terminal fragment of B-type natriuretic peptide (NT-proBNP). We used logistic regression to determine if these behaviors were associated with detectable hsTnT (>= 3ng/L) or with NT-proBNP in the highest quartile (≥117.4 ng/L). Results: The median (Q1-Q3) NT-proBNP of the cohort was 64.2 (37.8-117.4), and 30.3% (171/564) of the cohort had detectable circulating hsTnT. In adjusted models, women who drank 1-6 drinks per week had a lower odds of having a detectable hsTnT (OR 0.54, 95% CI: 0.33-0.89, P-trend=0.001) or an elevated NT-proBNP (OR 0.48, 95% CI 0.19-1.19, P-trend =0.03; Figure). We validated the results for B-type natriuretic peptide in a large independent cohort. No significant associations were seen for diet, exercise, or smoking. Conclusion: Regular alcohol consumption is associated with lower concentrations of hsTnT and NT-proBNP, two cardiovascular biomarkers associated with increased cardiovascular risk. These results raise the hypothesis that the beneficial effects of alcohol consumption may be mediated by direct effects on the myocardium.


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