Repeated Measurements of Cardiac Troponin T and N-Terminal Pro-B-Type Natriuretic Peptide to Assess Long-Term Mortality Risk in Subjects with Osteoarthritis

Osteoarthritis (OA) is associated with higher cardiovascular mortality risk. High-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) are well-characterized prognostic cardiac markers. We aimed to describe the changes in biomarkers measured one year apart in a cohort of 347 subjects with OA who underwent hip or knee replacement surgery in 1995/1996 and to analyze the prognostic value of repeated measurements for long-term mortality. During a median follow-up of 19 years, 209 (60.2%) subjects died. Substantial changes in cardiac biomarkers, especially for NT-proBNP, and an independent prognostic value of NT-proBNP for long-term mortality were found for both baseline measurement concentration (hazard ratio (HR) 1.32, 95% confidence interval (CI) (1.13–1.55)) and follow-up measurement concentration (HR 1.39, 95% CI 1.18–1.64) (all HR per standard deviation increase after natural log-transformation). Baseline concentrations were correlated with follow-up concentrations of NT-proBNP and no longer showed prognostic value when included simultaneously in a single model (HR 1.08, 95% CI 0.86–1.37), whereas the estimate for the one-year measurement remained robust (HR 1.31, 95% CI 1.04–1.66). Therefore, no significant additional benefit of repeated NT-proBNP measurements was found in this cohort, facilitating the use of a single NT-proBNP measurement as a stable prognostic marker.

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Long-term Prognostic Value of Asymptomatic Cardiac Troponin T Elevations in Patients After Major Vascular Surgery

Yearbook of Vascular Surgery ◽

10.1016/s0749-4041(08)70075-7 ◽

2006 ◽

Vol 2006 ◽

pp. 86-87

Author(s):

G.L. Moneta

Keyword(s):

Vascular Surgery ◽

Cardiac Troponin ◽

Prognostic Value ◽

Troponin T ◽

Cardiac Troponin T ◽

Major Vascular Surgery

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Independent prognostic value of serum creatine kinase isoenzyme MB mass, cardiac troponin T and myosin light chain levels in suspected acute myocardial infarction. Analysis of 28 months of follow-up in 196 patients

ACC Current Journal Review ◽

10.1016/1062-1458(96)86771-7 ◽

1996 ◽

Vol 5 (3) ◽

pp. 84

Keyword(s):

Cardiac Troponin ◽

Prognostic Value ◽

Myosin Light Chain ◽

Troponin T ◽

Serum Creatine Kinase ◽

Cardiac Troponin T ◽

Creatine Kinase Isoenzyme ◽

Suspected Acute Myocardial Infarction ◽

Creatine Kinase Isoenzyme Mb

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Cardiac Troponin T and Right Ventricular Systolic Pressure Predict Cardiovascular and Mortality Risk in Kidney Transplant Candidates

American Journal of Nephrology ◽

10.1159/000503807 ◽

2019 ◽

Vol 50 (6) ◽

pp. 434-443 ◽

Cited By ~ 1

Author(s):

Christine Firth ◽

Tripta Kaur ◽

Harini Chakkera ◽

Nan Zhang ◽

Fadi Shamoun ◽

...

Keyword(s):

Right Ventricular ◽

Mortality Risk ◽

Cardiac Troponin ◽

Troponin T ◽

Systolic Pressure ◽

Cardiac Troponin T ◽

Right Ventricular Systolic Pressure ◽

Ventricular Systolic Pressure ◽

Cv Disease

Background: Patients presenting for kidney transplant (KTx) evaluation are subject to high rates of mortality and cardiovascular (CV) events pre- and post-KTx. CV and mortality risk assessment is needed. Methods: We evaluated cardiac troponin T (cTnT) as a predictor of CV events and mortality in a racially diverse cohort with significant CV disease burden presenting for KTx evaluation. Right ventricular systolic pressure (RVSP) was also assessed in predicting these outcomes. The population consisted of 561 patients presenting for KTx evaluation from 2011 to 2013 at Mayo Clinic, Arizona. A cutoff value for cTnT and RVSP that was most associated with CV events or mortality was derived. Multivariate Cox regression analysis was used to assess cTnT, RVSP, traditional, and other risk factors for the outcomes of interest. Results: Mean age was 53.5 ± 13.7 years and the median follow-up after KTx evaluation was 48.0 months. The cohort was 70.6% (n = 392) White, 11.4% (n = 63) Black, 8.5% (n = 47) Native American, and 3.1% (n = 17) Asian. Preexisting CV disease at the time of evaluation was prevalent in 24.4% (n = 137) of patients. During follow-up, 66.3% (n = 372) received a KTx and 21.9% (n = 123) had a composite event (16.8% death, 6.6 % CV events). It was found that 70.7% (n = 87) of events occurred in patients who were not transplanted; 53.5% (n = 300) had an elevated cTnT (≥0.01 ng/mL, median 0.02 ng/mL) and 84.1% (n = 344) of patients with RVSP data had an elevated RVSP (>25 mm Hg). Time to event analysis identified a cTnT ≥0.036 ng/mL and RVSP ≥31 mm Hg to be best predictive of CV events and mortality. Smoking, CV disease, hypoalbuminemia, RVSP, and cTnT independently predicted CV events and mortality. Conclusion: Elevated cTnT and RVSP were independently predictive of CV events and mortality in the cohort. Clinicians should consider the value of RVSP and cTnT as markers of CV risk in KTx evaluation.

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