Abstract P010: Cardiac Troponin T Based On The Latest Generation Assay And Cardiovascular Disease: The Atherosclerosis Risk In Communities (ARIC) Study

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Yasuyuki Honda ◽  
Yejin Mok ◽  
Junichi Ishigami ◽  
Kellan E Ashley ◽  
Ron C Hoogeveen ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
General Population ◽  
Cardiac Troponin ◽  
Troponin T ◽  
High Sensitivity ◽  
Epidemiological Studies ◽  
Seemingly Unrelated Regression ◽  
Fourth Generation ◽  
Cardiac Troponin T ◽  
Limit Of Quantification

Background: High-sensitivity cardiac troponin T (TnT) is a potent predictor of cardiovascular disease (CVD) in the general population. Recently, the US FDA has approved Roche fifth generation (Gen 5) TnT assay (more sensitive than the fourth generation [Gen 4] TnT assay). Since many previous epidemiological studies used Gen 4 TnT, it is important to characterize the association of Gen 5 TnT with major CVD events. Methods: We first assessed correlation of Gen 5 vs. Gen 4 TnT in a subsample of 91 participants. Then, as the main analysis, we examined the association of Gen 5 TnT at visit 3 (1993-1995) with major CVD events (coronary heart disease [CHD], stroke, heart failure [HF], and peripheral artery disease [PAD]). Gen 5 TnT was categorized as <6 (limit of quantification), 6-<8, 8-<14, 14-<19, and ≥19 ng/L. CHD and stroke events were adjudicated whereas HF and PAD were based on hospitalization codes. We also conducted a subgroup analysis by prevalent CVD at baseline. Results: Gen 5 TnT and Gen 4 TnT had a correlation coefficient of 0.98 (0.88 after excluding outliers >3SD). Of 11,979 participants (mean age 60 [SD 6] years, 1,840 [15%] with prevalent CVD), 5,856 (49%) participants had quantifiable levels of TnT. During a median follow-up of 22.1 years, there were 1,850 CHD events, 1,075 stroke events, 2,908 HF cases, and 571 PAD cases. Gen 5 TnT showed a robust dose response association with each CVD type, with adjusted hazard ratio 2-4 for TnT ≥19 (vs.<6) ng/L ( Table ). Even the category 6-<8 ng/L showed significantly elevated risk for all outcomes except stroke. The associations were stronger for HF and PAD than CHD or stroke (all p-values using seemingly unrelated regression <0.001). The associations were similar regardless of baseline CVD status. Conclusions: Gen 5 TnT was highly correlated with Gen 4 TnT and gave quantifiable values in half middle-aged adults. Gen 5 TnT was robustly associated with major CVD events (especially HF and PAD) in the general population, supporting its usefulness in epidemiological research and clinical practice.

scholarly journals Determinants of minimal elevation in high-sensitivity cardiac troponin T in the general population

2016 ◽  
Vol 49 (9) ◽  
pp. 657-662 ◽  
Author(s):  
Jonathan Rubin ◽  
Kunihiro Matsushita ◽  
Mariana Lazo ◽  
Christie M. Ballantyne ◽  
Vijay Nambi ◽  
...  
Keyword(s):  
General Population ◽  
Cardiac Troponin ◽  
Troponin T ◽  
High Sensitivity ◽  
Cardiac Troponin T

scholarly journals Release Kinetics of Cardiac Biomarkers in Patients Undergoing Transcoronary Ablation of Septal Hypertrophy

2012 ◽  
Vol 58 (6) ◽  
pp. 1049-1054 ◽  
Author(s):  
Christoph Liebetrau ◽  
Helge Möllmann ◽  
Holger Nef ◽  
Sebastian Szardien ◽  
Johannes Rixe ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
Troponin T ◽  
Release Kinetics ◽  
High Sensitivity ◽  
Cardiac Biomarkers ◽  
Fourth Generation ◽  
Cardiac Troponin T ◽  
Creatine Kinase Mb ◽  
Septal Hypertrophy ◽  
Kinetics Of

Abstract BACKGROUND The release kinetics of cardiac troponin T measured with conventional vs high-sensitivity cardiac troponin T (hs-cTnT) assays in patients with acute myocardial infarction (AMI) is difficult to establish. METHODS We analyzed the release kinetics of cTnT measured by fourth generation and high-sensitivity assays, creatine kinase-MB (CK-MB), and myoglobin in patients with hypertrophic obstructive cardiomyopathy undergoing transcoronary ablation of septal hypertrophy (TASH), a model of AMI. Consecutive patients (n = 21) undergoing TASH were included. Serum and EDTA-plasma samples were collected before and at 15, 30, 45, 60, 75, 90, and 105 min, and 2, 4, 8, and 24 h after TASH. RESULTS cTnT concentrations measured by the hs assay were significantly increased at 15 min [21.4 ng/L, interquartile range (IQR) 13.3–39.7 ng/L vs 11.3 ng/L, IQR 6.0–18.8 ng/L at baseline; P = 0.031]. In comparison, cTnT concentrations measured by the conventional fourth generation assay increased significantly at 60 min (30.0 ng/L, IQR 20.0–30.0 ng/L vs &lt;10.0 ng/L, IQR &lt;10.0–10.0 ng/L; P &lt; 0.01), CK-MB at 90 min (8.4 μg/L, IQR 6.9–14.4 μg/L vs 0.9 μg/L, IQR 0.4–1.1 μg/L; P &lt; 0.01), and myoglobin at 30 min (188.0 μg/L, IQR 154.0–233.0 μg/L vs 38.0 μg/L, IQR 28.0–56.0; P &lt; 0.01). CONCLUSIONS cTnT concentrations measured by the hs assay were significantly increased after TASH at all of the time points, with a doubling at 15 min after induction of AMI, confirming earlier evidence of myocardial injury compared to the fourth generation cTnT assay and CK-MB and myoglobin.

Use of a new high-sensitivity assay for cardiac troponin T to stratify the risk of cardiovascular disease in outpatients with type-2 diabetes

2011 ◽  
Vol 3 (1) ◽  
pp. 29-36 ◽  
Author(s):  
Shogo Asano ◽  
Atsushi Suzuki ◽  
Junnichi Ishii ◽  
Sahoko Sekiguchi-Ueda ◽  
Megumi Shibata ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Cardiac Troponin ◽  
Troponin T ◽  
High Sensitivity ◽  
Cardiac Troponin T

scholarly journals Prognostic value of elevated high-sensitivity cardiac troponin T levels in a low risk outpatient population with cardiovascular disease

2016 ◽  
Vol 5 (6) ◽  
pp. 409-418 ◽  
Author(s):  
Moritz Biener ◽  
Evangelos Giannitsis ◽  
Judith Lamerz ◽  
Matthias Mueller-Hennessen ◽  
Mehrshad Vafaie ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cardiac Troponin ◽  
Prognostic Value ◽  
Troponin T ◽  
High Sensitivity ◽  
Low Risk ◽  
Cardiac Troponin T

scholarly journals Analytical Validation of a High-Sensitivity Cardiac Troponin T Assay

2010 ◽  
Vol 56 (2) ◽  
pp. 254-261 ◽  
Author(s):  
Evangelos Giannitsis ◽  
Kerstin Kurz ◽  
Klaus Hallermayer ◽  
Jochen Jarausch ◽  
Allan S Jaffe ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
Task Force ◽  
Troponin T ◽  
High Sensitivity ◽  
Final Diagnosis ◽  
Analytical Performance ◽  
Fourth Generation ◽  
Cardiac Troponin T ◽  
Analytical Sensitivity ◽  
Number Of Patients

Abstract Background: We report the development of a novel high-sensitivity cardiac troponin T (hs-cTnT) assay, a modification of the Roche fourth-generation cTnT assay, and validation of the analytical performance of this assay. Methods: Validation included testing of analytical sensitivity, specificity, interferences, and precision. We established the 99th percentile cutoff from healthy reference populations (n = 616). In addition, we studied differences in time to a positive result when using serial measurements of hs-cTnT vs cTnT in patients with a confirmed diagnosis of non-ST elevation myocardial infarction (non-STEMI). Results: The hs-cTnT assay had an analytical range from 3 to 10 000 ng/L. At the 99th percentile value of 13.5 ng/L, the CV was 9% using the Elecsys® 2010 analyzer. The assay was specific for cTnT without interferences from human cTnI or cTnC, skeletal muscle TnT, or hemoglobin concentrations up to 1000 mg/L, above which falsely lower values would be expected. When the assay was evaluated clinically, a hs-cTnT higher than the 99th percentile concentration identified a significantly higher number of patients with non-STEMI on presentation (45 vs 20 patients, P = 0.0004) compared with cTnT, and a final diagnosis of non-STEMI was made in 9 additional patients (55 vs 46 patients, P = 0.23) after serial sampling. Time to diagnosis was significantly shorter using hs-cTnT compared with cTnT [mean 71.5 (SD 108.7) min vs 246.9 (82.0) min, respectively; P &lt; 0.01]. Conclusions: The analytical performance of hs-cTnT complies with the ESC-ACCF-AHA-WHF Global Task Force recommendations for use in the diagnosis of MI.

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