scholarly journals Growth Differentiation Factor‐15 Predicts Death and Stroke Event in Outpatients With Cardiovascular Risk Factors: The J‐HOP Study

2021 ◽  
Author(s):  
Keita Negishi ◽  
Satoshi Hoshide ◽  
Masahisa Shimpo ◽  
Hiroshi Kanegae ◽  
Kazuomi Kario
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Troponin T ◽  
High Sensitivity ◽  
Cardiac Events ◽  
Growth Differentiation Factor 15 ◽  
High Sensitivity Troponin ◽  
High Sensitivity Troponin T

Background Growth differentiation factor‐15 (GDF‐15) has emerged as a novel biomarker to predict all‐cause death in community‐dwelling individuals and patients with cardiovascular disease. We evaluated the prognostic value of GDF‐15 in outpatients with cardiovascular risk factors. Methods and Results GDF‐15 levels were measured in 3562 outpatients with cardiovascular risk factors in the J‐HOP (Japan Morning Surge‐Home Blood Pressure) study, a nationwide prospective study. Participants were stratified according to tertiles of GDF‐15 and followed up for all‐cause death and cardiovascular disease. During a mean follow‐up period of 6.6 years, there were 155 all‐cause deaths, 81 stroke events including cerebral infarction and intracranial hemorrhage, and 141 cardiac events including cardiac artery disease and heart failure. Patients with higher GDF‐15 levels were associated with risks of all‐cause death and stroke events (except for cardiac events) after adjustment for traditional risk factors and other prognostic biomarkers (NT‐proBNP [N‐terminal pro‐B‐type natriuretic peptide], high‐sensitivity troponin T; all‐cause death, hazard ratio, 2.38; 95% CI, 1.26–4.48; P =0.007; stroke events, hazard ratio, 2.93; 95% CI, 1.31–6.56, P =0.009; compared with the lowest tertile). Furthermore, incorporating GDF‐15 to the predictive models for all‐cause death improved discrimination and reclassification significantly. For stroke events, GDF‐15 showed similar diagnostic accuracy to NT‐proBNP and high‐sensitivity troponin T. Conclusions In Japanese outpatients with cardiovascular risk factors, GDF‐15 improves risk stratification for all‐cause death when compared with NT‐proBNP and high‐sensitivity troponin T. GDF‐15 was associated with increased risks of stroke events beyond conventional risk factors and other prognostic markers; however, the predictive ability for stroke events was equivalent to NT‐proBNP and high‐sensitivity troponin T. Registration URL: http://www.umin.ac.jp/ctr .; Unique identifier: UMIN000000894.

scholarly journals High-sensitivity troponin I and all-cause mortality in patients with stable COPD: an analysis of the COSYCONET study

2019 ◽  
Vol 55 (2) ◽  
pp. 1901314 ◽  
Author(s):  
Benjamin Waschki ◽  
Peter Alter ◽  
Tanja Zeller ◽  
Christina Magnussen ◽  
Johannes T. Neumann ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Diseases ◽  
Cardiovascular Risk Factors ◽  
Troponin I ◽  
High Sensitivity ◽  
Airflow Limitation ◽  
Reference Limit ◽  
High Sensitivity Troponin ◽  
All Cause Mortality

Chronic obstructive pulmonary disease (COPD) is a leading cause of death with a considerable part of the population dying from cardiovascular diseases. High-sensitivity troponin I (hs-TnI) might help to better identify COPD patients at high risk of mortality. We aimed to study the predictive value of hs-TnI for all-cause mortality beyond established COPD assessments, and after consideration of relevant cardiovascular risk factors and prevalent cardiovascular diseases, in a broad population with stable COPD.Circulating hs-TnI concentrations together with a wide range of respiratory and cardiovascular markers were evaluated in 2085 patients with stable COPD across all severity stages enrolled in the multicentre COSYCONET cohort study. The primary outcome was all-cause mortality over 3 years of follow-up.Hs-TnI was detectable in 2020 (96.9%) patients. The median hs-TnI concentration was 3.8 ng·L−1 (interquartile range 2.5–6.6 ng·L−1), with levels above the 99th percentile reference limit of 27 ng·L−1 observed in 1.8% of patients. In Cox regression analyses including adjustments for airflow limitation, dyspnoea grade, exercise capacity and history of severe exacerbations, as well as traditional cardiovascular risk factors, estimated glomerular filtration rate, ankle–brachial index, N-terminal pro-brain natriuretic peptides and prevalent cardiovascular diseases, hs-TnI was a significant predictor for all-cause mortality, both as a continuous variable (hazard ratio (HR) for log hs-TnI 1.28, 95% CI 1.01–1.62) and categorised according to the cut-off of 6 ng·L−1 (HR 1.63, 95% CI 1.10–2.42).In patients with stable COPD, hs-TnI is a strong predictor of all-cause mortality beyond established COPD mortality predictors, and independent of a broad range of cardiovascular risk factors and prevalent cardiovascular diseases. Hs-TnI concentrations well below the upper reference limit provide further prognostic value for all patients with COPD when added to established risk assessments.

High-sensitivity Troponin T Assay in Asymptomatic High Cardiovascular Risk Patients. The TUSARC Registry

2017 ◽  
Vol 70 (4) ◽  
pp. 261-266
Author(s):  
Isabel Álvarez ◽  
Luis Hernández ◽  
Héctor García ◽  
Vicente Villamandos ◽  
María Gracia López ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Troponin T ◽  
High Sensitivity ◽  
High Cardiovascular Risk ◽  
High Sensitivity Troponin ◽  
Risk Patients ◽  
High Sensitivity Troponin T

scholarly journals Prognostic Significance of High-Sensitivity Cardiac Troponin T Concentrations between the Limit of Blank and Limit of Detection in Community-Dwelling Adults: A Metaanalysis

2015 ◽  
Vol 61 (12) ◽  
pp. 1524-1531 ◽  
Author(s):  
Ravi H Parikh ◽  
Stephen L Seliger ◽  
James de Lemos ◽  
Vijay Nambi ◽  
Robert Christenson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Cardiac Troponin ◽  
Limit Of Detection ◽  
Troponin T ◽  
High Sensitivity ◽  
Hazard Ratio ◽  
Cardiac Troponin T

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).

scholarly journals Cardiovascular disease and excess mortality in depression: physical activity as a game changer

2021 ◽  
Vol 72 (6) ◽  
pp. 261-270
Author(s):  
M Gerber ◽  
MC Claussen ◽  
R Cody ◽  
C Imboden ◽  
S Ludyga ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Excess Mortality ◽  
Premature Mortality ◽  
Physical And Mental Health ◽  
Cardiac Events ◽  
Increased Risk

Problem: Depression is a widespread disorder and among the leading causes of disability worldwide. In this article, we perform an umbrella review on the association between depression and excess mortality, cardiovascular disease (CVD), and cardiovascular risk factors. We also provide an overview of mechanisms that explain these associations. Finally, we discuss clinical implications from a general perspective and discuss the potential of physical activity to favorably influence the relationship between depression and premature mortality. Methods: Meta-analyses were identified via PubMed. Only works on unipolar depression were included. Results: The association between depression and excess mortality is a robust epidemiological finding. This association can be attributed to the fact that people with depression are at increased risk for CVD and accumulate more cardiovascular risk factors. However, the causal associations are complex. While depression is associated with incident CVD, depression can also be a consequence of cardiac events. Regular physical activity and higher cardiorespiratory fitness levels mitigate the risk of premature mortality associated with depression. Discussion: More attention should be paid to the physical health of psychiatric patients. High priority should be given to the promotion of physical activity and fitness, as they are beneficial for both physical and mental health. Key Words: Fitness, Cardiovascular Disease, Physical Activity, Mortality

scholarly journals Comparison between High-Sensitivity Cardiac Troponin T and Cardiac Troponin I in a Large General Population Cohort

2018 ◽  
Vol 64 (11) ◽  
pp. 1607-1616 ◽  
Author(s):  
Paul Welsh ◽  
David Preiss ◽  
Anoop S V Shah ◽  
David McAllister ◽  
Andrew Briggs ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
General Population ◽  
Cardiovascular Risk Factors ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Troponin T ◽  
High Sensitivity ◽  
General Population Cohort ◽  
Age And Sex

Abstract BACKGROUND Few data compare cardiac troponin T (cTnT) and cardiac troponin I (cTnI) in a general population. We sought to evaluate the distribution and association between cTnT, cTnI, and cardiovascular risk factors in a large general population cohort. METHODS High-sensitivity cTnT and cTnI were measured in serum from 19501 individuals in the Generation Scotland Scottish Family Health Study. Associations with cardiovascular risk factors were compared using age- and sex-adjusted regression. Observed age- and sex-stratified 99th centiles were compared with 99th centiles for cTnT (men, 15.5 ng/L; women, 9.0 ng/L) and cTnI (men, 34.2 ng/L; women, 15.6 ng/L) used in clinical practice. RESULTS cTnT and cTnI concentrations were detectable in 53.3% and 74.8% of participants, respectively, and were modestly correlated in unadjusted analyses (R2 = 21.3%) and only weakly correlated after adjusting for age and sex (R2 = 9.5%). Cardiovascular risk factors were associated with both troponins, but in age- and sex-adjusted analyses, cTnI was more strongly associated with age, male sex, body mass index, and systolic blood pressure (P < 0.0001 for all vs cTnT). cTnT was more strongly associated with diabetes (P < 0.0001 vs cTnI). The observed 99th centiles were broadly consistent with recommended 99th centiles in younger men and women. After the age of 60 years, observed 99th centiles increased substantially for cTnT, and beyond 70 years of age, the 99th centiles approximately doubled for both troponins. CONCLUSIONS In the general population, cTnT and cTnI concentrations are weakly correlated and are differentially associated with cardiovascular risk factors. The 99th centiles currently in use are broadly appropriate for men and women up to but not beyond the age of 60 years.

Sign in / Sign up

Export Citation Format

Share Document