Highly sensitive serum cardiac troponin T and cardiovascular events in patients with systemic lupus erythematosus (TROPOPLUS study)

Abstract Objective Identification of biological markers able to better stratify cardiovascular risks in SLE patients is needed. We aimed to determine whether serum cardiac troponin T (cTnT) levels measured with a highly sensitive assay [high sensitivity cTnT (HS-cTnT)] may predict cardiovascular events (CVEs) in SLE. Method All SLE patients included between 2007 and 2010 in the randomized, double-blind, placebo-controlled, multicentre PLUS trial were screened. Patients with no past history of CVE at inclusion and a follow-up period of >20 months were analysed. HS-cTnT concentration was measured using the electrochemiluminescence method on serum collected at PLUS inclusion. The primary outcome was the incident CVE. Factors associated with the primary outcome were identified and multivariate analysis was performed. Results Overall, 442 SLE patients (of the 573 included in the PLUS study) were analysed for the primary outcome with a median follow up of 110 (interquartile range: 99–120) months. Among them, 29 (6.6%) experienced at least one CVE that occurred at a median of 67 (interquartile range: 31–91) months after inclusion. Six out of 29 patients had more than one CVE. In the multivariate analysis, dyslipidaemia, age and HS-cTnT were associated with the occurrence of CVE. Kaplan–Meier analysis showed that a concentration of HS-cTnT > 4.27 ng/l at inclusion increased by 2.7 [hazard ratio 2.7 (95% CI: 1.3, 5.6), P =0.0083] the risk of CVE in SLE. Conclusion HS-cTnT measured in serum is the first identified biomarker independently associated with incident CVE in SLE patients.

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SAT0201 ASSOCIATION OF CARDIAC TROPONIN T MEASURED WITH A HIGHLY SENSITIVE ASSAY WITH CARDIOVASCULAR EVENTS IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS (TROPOPLUS STUDY)

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.350 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1043.1-1043

Author(s):

J. Chezel ◽

N. Costedoat-Chalumeau ◽

D. Rouzaud ◽

V. Le Guern ◽

C. Gobeaux ◽

...

Keyword(s):

Lupus Erythematosus ◽

Cardiac Troponin ◽

Primary Outcome ◽

Troponin T ◽

Cardiac Troponin T ◽

Sensitive Assay ◽

Systemic Lupus ◽

Research Support ◽

Highly Sensitive

Background:Mortality is still 2 to 5 times superior in SLE patients as compared to general population and is mainly due to cardiovascular event (CVE). Although cardiovascular traditional risk factors contribute to early-onset atherosclerosis in SLE, the phenomenon is not fully explained by a higher frequency of smoking habits, hypertension, or dyslipidemia and the Framingham risk equation usually underestimates the 10-year cardiovascular risk in this population. Thus, identification of biological markers able to better stratify cardiovascular risks in SLE patients is needed.Objectives:Our study aimed to determine whether serum cardiac troponin T measured with a highly sensitive assay (HS-cTnT) was associated with CVE in systemic lupus erythematosus (SLE) patients.Methods:All SLE patients included between 2007 and 2010 in the randomized, double-blind, placebo-controlled, multicenter PLUS trial were retrospectively screened. Patients with no past history of CVE and a follow-up period of > 20 months were analyzed. HS-cTnT concentration was measured using the electrochemiluminescence method on serum collected at PLUS inclusion. The primary outcome was the incident CVE. Factors associated with the primary outcome were identified and multivariate analysis was performed.Results:Overall, 442 SLE patients (of the 573 included in the PLUS study) were analyzed for the primary outcome with a median follow up of 110 (IQR: 99-120) months. Among them 29 (6.6%) experienced at least one CVE that occurred at a median of 67 (IQR: 31-91) months after inclusion. Six out of 29 patients had more than one CVE. In the multivariate analysis, dyslipidemia, duration of SLE disease and HS-cTnT were associated with the occurrence of CVE. Kaplan-Meier analysis showed that a concentration of HS-cTnT>4.27 ng/L at inclusion increased by 2.7 (HR 2.7 [1.3-5.6], p=0.0083) the risk of CVE in SLE.Conclusion:HS-cTnT measured in serum is the first identified biomarker independently associated with incident CVE in SLE patientsDisclosure of Interests:Julie Chezel: None declared, Nathalie Costedoat-Chalumeau Grant/research support from: UCB to my institution, Diane Rouzaud: None declared, Véronique LE GUERN Grant/research support from: UCB for GR2 study (to our institution), Camille Gobeaux: None declared, Nathalie Morel: None declared, Micheline Pha: None declared, Zahir Amoura: None declared, Thomas Papo: None declared, karim sacre: None declared

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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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Estimated Glomerular Filtration Rate is a Predictive Factor for High-Sensitivity Cardiac Troponin T in a Community-Based 4.8-year Prospective Study

10.21203/rs.3.rs-31724/v1 ◽

2020 ◽

Author(s):

Jie Han ◽

Xiaona Wang ◽

Ping Ye ◽

Ruihua Cao ◽

Wenkai Xiao ◽

...

Keyword(s):

Cardiac Troponin ◽

Filtration Rate ◽

Myocardial Injury ◽

Estimated Glomerular Filtration Rate ◽

Troponin T ◽

Cardiac Troponin T ◽

Community Based ◽

Highly Sensitive ◽

The Relationship

Abstract Objectives: Persistent elevation of cardiac troponin T (cTnT), which is considered as a sensitive and specific biomarker of myocardial injury, is frequently observed in patients with renal insufficiency. Meanwhile, estimated glomerular filtration rate (eGFR) is an independent risk factor of cardiovascular diseases. With a highly sensitive assay, the prevalence of detectable highly sensitive cTnT (hs-cTnT) is greatly improved even in general population. The aim of this study was to better understand the relationship between renal function (eGFR) and myocardial injury (hs-cTnT) in a community-based population.Methods: We analyzed the relationship between baseline eGFR and follow-up hs-cTnT, and the change of hs-cTnT in 1354 participants after 4.8 years follow-up.Results: In Pearson’s correlation analysis, baseline eGFR showed a negative relationship with follow-up hs-cTnT (r=-0.439; P < 0.001). In multiple linear regression analysis, baseline eGFR was independently and negatively associated with follow-up hs-cTnT (β=-0.310, P = 0.005). Stepwise logistic regression models revealed that baseline eGFR was significantly associated with the change in hs-cTnT after 4.8 years follow-up. However, the change in eGFR was not associated with the change in hs-cTnT.Conclusions: Baseline eGFR levels were independently and negatively associated with follow-up hs-cTnT. Furthermore, baseline eGFR levels were an independent predictor of the change in hs-cTnT 4.8 years follow-up, indicating a relationship between renal function and myocardial injury in a community-based population.

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High-Sensitivity Cardiac Troponin T is A Risk Factor for Major Adverse Cardiovascular Events and All-Cause Mortality: 9.5 Year Follow-up Study

10.21203/rs.3.rs-68461/v1 ◽

2020 ◽

Author(s):

Xiaona Wang ◽

Ruihua Cao ◽

Xu Yang ◽

Wenkai Xiao ◽

Yun Zhang ◽

...

Keyword(s):

Cardiac Troponin ◽

Cardiovascular Events ◽

Troponin T ◽

High Sensitivity ◽

Major Adverse Cardiovascular Events ◽

Cardiac Troponin T ◽

Follow Up Study ◽

All Cause Mortality ◽

Coronary Events

Abstract Background: The relationship between high-sensitivity cardiac troponin T (hs-cTnT) and different cardiovascular events has been observed in several large community studies, and the results have been controversial. However, there is currently no cross-sectional or longitudinal follow-up study on hs-cTnT in the Chinese population.Methods: We analyzed the association of plasma hs-cTnT levels with major adverse cardiovascular events and all-cause mortality in 1325 subjects from a longitudinal follow-up community-based population in Beijing, China.Results: In the Cox proportional hazards models analysis, the risk of MACE increased with the increase of hs-cTnT levels (HR, 1.223, 95% CI, 1.054–1.418, P = 0.008). Increased hs-cTnT levels were associated with coronary events (HR, 1.391, 95% CI, 1.106–1.749, P = 0.005) in Model 4. Cox proportional risk regression model analysis revealed that increased hs-cTnT levels were associated with an increased risk of mortality (HR, 1.763, 95% CI, 1.224–2.540, P = 0.002), even after adjusting hs-CRP and NT-proBNP. The area under the ROC curve for predicting MACE was 0.559 (95% CI, 0.523–0.595, P = 0.001). The areas under the ROC curve for predicting coronary events and mortality were 0.629 (95% CI, 0.580–0.678, P < 0.001) and 0.644 (95% CI, 0.564–0.725, P < 0.001), respectively.Conclusions: Our findings in the Chinese cohort support that hs-cTnT is a risk factor for major adverse cardiovascular events and all-cause mortality.

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Abstract MP26: Highly Sensitive Cardiac Troponin T is Associated with Cognitive Function and Incidence of Dementia

Circulation ◽

10.1161/circ.127.suppl_12.amp26 ◽

2013 ◽

Vol 127 (suppl_12) ◽

Author(s):

Andrea L Schneider ◽

Andreea M Rawlings ◽

A. R Sharrett ◽

Alvaro Alonso ◽

Thomas Mosley ◽

...

Keyword(s):

Test Scores ◽

Cardiac Troponin ◽

Troponin T ◽

Myocardial Damage ◽

Cognitive Test ◽

Cardiac Troponin T ◽

Cross Sectional ◽

Dementia Risk ◽

Highly Sensitive

Introduction: Clinical cardiovascular disease is a major risk factor for cognitive impairment and dementia, but less is known about the association of subclinical myocardial damage (measured by highly sensitive cardiac troponin T [hs-cTnT]) with cognition and dementia in the general population. Hypothesis: We hypothesized that higher levels of hs-cTnT would be associated with lower cognitive test scores and increased risk of dementia. Methods: We conducted cross-sectional (1996-1998) and prospective (follow-up through 2009) analyses of 8,601 participants in the ARIC Study without a history of cardiovascular disease or stroke. Cognition was measured by 3 tests: Delayed Word Recall (DWR), Digit Symbol Substitution (DSS), and Word Fluency (WF). Dementia was defined using ICD-9 codes. Linear regression and Cox proportional hazards models were adjusted for demographic, lifestyle, and cardiovascular factors. Results: 66% of participants had detectable hs-cTnT (≥0.003 μg/L) (mean age 63; 59% female; 20% black). In cross-sectional analyses, higher hs-cTnT was associated with lower scores on DSS (p-trend <0.001) and WF (p-trend=0.002), but not DWR (p-trend=0.09) (Table). Similarly, hs-cTnT ≥0.014 μg/L (≥99th percentile) vs. <0.014 μg/L was associated with lower scores on DSS (-1.78 points [95% CI: -2.61, -0.95]) and WF (-1.04 words [95% CI: -2.00, -0.07]), but not on DWR. Over a median of 12 years, there were 338 incident dementia cases. In prospective analyses, higher baseline levels of hs-cTnT were associated with increased dementia risk (p-trend <0.001) (Table). Conclusion: Higher levels of hs-cTnT were associated with lower cognitive test scores at baseline and increased dementia risk during follow-up. Our results suggest that subclinical myocardial damage is associated with cognition and dementia. This association may be driven by shared risk factors for myocardial and cerebral injury or as a direct result of subclinical small vessel or cardiac disease; more work is needed to elucidate potential mechanisms.

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High-Sensitivity Cardiac Troponin T Is a Risk Factor for Major Adverse Cardiovascular Events and All-Cause Mortality: A 9.5-Year Follow-Up Study

Cardiology Research and Practice ◽

10.1155/2021/6647987 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Xiaona Wang ◽

Peiqi Wang ◽

Ruihua Cao ◽

Xu Yang ◽

Wenkai Xiao ◽

...

Keyword(s):

Cardiac Troponin ◽

Cardiovascular Events ◽

Troponin T ◽

High Sensitivity ◽

Major Adverse Cardiovascular Events ◽

Cardiac Troponin T ◽

Follow Up Study ◽

All Cause Mortality ◽

Coronary Events

Background. The relationship between high-sensitivity cardiac troponin T (hs-cTnT) and different cardiovascular events has been observed in several large community studies, and the results have been controversial. However, there is currently no cross-sectional or longitudinal follow-up study on hs-cTnT in the Chinese population. Methods. We analyzed the association of plasma hs-cTnT levels with major adverse cardiovascular events (MACEs) and all-cause mortality in 1325 subjects from a longitudinal follow-up community-based population in Beijing, China. Results. In the Cox proportional hazards models analysis, the risk of MACEs increased with the increase of hs-cTnT levels (HR, 1.223, 95% CI, 1.054–1.418, P = 0.008 ). Increased hs-cTnT levels were associated with coronary events (HR, 1.391, 95% CI, 1.106–1.749, P = 0.005 ) in Model 4. Cox proportional risk regression model analysis revealed that increased hs-cTnT levels were associated with an increased risk of mortality (HR, 1.763, 95% CI, 1.224–2.540, P = 0.002 ), even after adjusting hs-CRP and NT-proBNP. The area under the ROC curve for predicting MACEs was 0.559 (95% CI, 0.523–0.595, P = 0.001 ). The areas under the ROC curve for predicting coronary events and mortality were 0.629 (95% CI, 0.580–0.678, P < 0.001 ) and 0.644 (95% CI, 0.564–0.725, P < 0.001 ), respectively. Conclusions. Our findings in the Chinese cohort support that hs-cTnT is a risk factor for major adverse cardiovascular events and all-cause mortality.

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