Systemic Cardiac Troponin T Associated With Incident Atrial Fibrillation Among Patients With Suspected Stable Angina Pectoris

Abstract Funding Acknowledgements Type of funding sources: None. Background/Aim Increased plasma trimetyllysine (TML), a methylated amino acid, has recently been linked to higher risk of acute myocardial infarction (AMI). TML is also a precursor of trimethylamine-N oxide (TMAO), which has been linked to increased cardiovascular risk, including that of atrial fibrillation (AF). We investigated the association between TML and new-onset AF in two large Norwegian cohorts. Methods The primary cohort consisted of 6396 participants in the community-based Hordaland Health Study (HUSK). The validation cohort consited of 2027 patients who underwent coronary angiography due to suspected stable angina pectoris in the Western Norway Coronary Angiography Cohort (WECAC). Information on new-onset AF was obtained by linking patient data to Norwegian public health registries. Risk associations were explored by Cox regression. Results During median (25th-75th percentile) follow-up of 10.9 (10.6-11.3) and 7.0 (6.3-8.6) years, 560 (8.8%) patients in the HUSK and 210 (10.4%) in the WECAC was diagnosed with AF. In the HUSK, the age and gender adjusted HR (95 % CI) for the 4th vs. 1st plasma TML quartiles 1.84 (1.37-2.48) p < 0.001. In multivariable models the association was only slightly attenuated. Correspondingsly, the age and gender adjusted HR (95% CI) for the 4th vs. 1st TML quartiles in the WECAC was 1.48 (0.96-2.27) p = 0.07. Testing for collinearity between TMAO and TML revealed variance inflation factors between 1.0-1.1 in HUSK and WECAC, thus ruling out collinearity. Conclusion Plasma TML was associated with new-onset AF among subjects from the general population, and the relationship was independent from established AF risk factors. A similar trend was also seen in patients with suspected stable angina pectoris, strengthening our findings, which motivate further studies to explore potential pathophysiological relationships between one-carbon metabolism and cardiac arrhythmias

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Perioperative cardiac troponin T and risk of postoperative atrial fibrillation in coronary artery bypass graft surgery

Critical Pathways in Cardiology ◽

10.1097/hpc.0000000000000276 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Ali Vasheghani Farahani ◽

Abbas Salehi Omran ◽

Kyomars Abbasi ◽

Ali Gholamrezaei ◽

Pejman Mansouri ◽

...

Keyword(s):

Atrial Fibrillation ◽

Coronary Artery ◽

Coronary Artery Bypass Graft ◽

Coronary Artery Bypass ◽

Cardiac Troponin ◽

Troponin T ◽

Artery Bypass ◽

Bypass Graft ◽

Cardiac Troponin T ◽

Artery Bypass Graft

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SOLUBLE ST2 AND HIGH SENSITIVITY CARDIAC TROPONIN-T LEVELS PREDICT ATRIAL FIBRILLATION ABLATION OUTCOME

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(16)30841-5 ◽

2016 ◽

Vol 67 (13) ◽

pp. 840

Author(s):

Vincent Y. See ◽

Timm Dickfeld ◽

Stephen Shorofsky ◽

Anastasios Saliaris ◽

Benjamin Remo ◽

...

Keyword(s):

Atrial Fibrillation ◽

Cardiac Troponin ◽

Troponin T ◽

High Sensitivity ◽

Atrial Fibrillation Ablation ◽

Cardiac Troponin T ◽

Soluble St2

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P1881High-sensitivity cardiac troponin T in patients with acute atrial fibrillation

European Heart Journal ◽

10.1093/eurheartj/ehz748.0629 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

R Arbucci ◽

S Haseeb ◽

R Campos ◽

M Trivi ◽

J P Costabel

Keyword(s):

Atrial Fibrillation ◽

Multivariate Analysis ◽

Cardiac Troponin ◽

Cardiovascular Events ◽

Troponin T ◽

Major Adverse Cardiovascular Events ◽

Cardiac Troponin T ◽

Coronary Syndrome ◽

Atrial Area ◽

Af Recurrence

Abstract Background Atrial Fibrillation (AF) is the most common sustained cardiac arrhythmia encountered in clinical practice and confers a significant burden to morbidity and mortality. High-sensitivity cardiac troponin T (hs-cTnT) levels have provided a significant contribution in the early diagnosis of cardiovascular events; however, the significance of hs-cTnT elevation in the setting of acute AF is not clearly understood. Purpose The aim of this study was to evaluate the factors associated with hs-cTnT elevation and its prognostic implication in patients with acute AF. Methods This single-center prospective study included 406 consecutive patients who presented to the emergency department (ED) with acute AF. Acute AF was defined as a rapid, irregular, and chaotic atrial activity of <48 hours' duration including both the first symptomatic onset of chronic or persistent AF, and episodes of paroxysmal AF. The association between hs-cTnT and outcomes were evaluated using multivariate analyses. Results The mean age of the population was 67.3±12.2 and 74% were male. The median time from the onset of symptoms to ED consultation was 230 minutes (interquartile range: 123–450 minutes). The median hs-cTnT value was 12 ng/L, with 39% of patients with values above the 99 thpercentile. AF was reverted to sinus rhythm in 76% of the patients (83% attempted cardioversion). At one-year, AF recurrence was observed in 38% of the patients and major adverse cardiovascular events (MACE) (death, myocardial infarction, acute coronary syndrome or stroke) were observed in 6% of the patients. After adjusting for demographic and clinical characteristics in multivariate analysis, hs-cTnT elevation was associated with increasing age and left atrial area (p=0.001). Hs-cTnT levels were not associated with 1-year AF recurrence (p=0.132) or with AF reversion (p=0.869). Hs-cTnT levels were significantly higher in patients who experienced MACE at 1-year (12 ng/L vs 24 ng/L, p=0.001) and hs-cTnT was a predictor of MACE on multivariate analysis (OR 3.486, 95% CI 1.256–5.379, p=0.009). Variable Result AF rate 110 (90–118) Atrial area, cm2 22 (19–27) Cardioversion attemped 82.5% Conclusions Hs-cTnT elevation accounted for a large proportion of patients with acute AF. Elevated levels of hs-cTnT were not associated with AF reversion or with 1-year AF recurrence, however hs-cTnT was highly predictive of MACE at 1-year.

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