Detectable High-Sensitivity Cardiac Troponin within the Population Reference Interval Conveys High 5-Year Cardiovascular Risk: An Observational Study

Clinical Chemistry
Martin ThanJohn W Pickering

Abstract

Increased cardiac troponin I or T detected by high-sensitivity assays (hs-cTnI or hs-cTnT) confers an increased risk of adverse prognosis. We determined whether patients presenting with putatively normal, detectable cTn concentrations [> limit of detection and < upper reference limit (URL)] have increased risk of major adverse cardiovascular events (MACE) or all-cause mortality. A prospective 5-year follow-up of patients recruited in the emergency department with possible acute coronary syndrome (ACS) and cTn concentrations measured with hs-cTnI (Abbott) and hs-cTnT (Roche) assays. Cox regression models were generated with adjustment for covariates in those without MACE on presentation. Hazard ratios (HRs) for hs-cTn were calculated relative to the HRs at the median concentration. Of 1113 patients, 836 were without presentation MACE. Of these, 138 incurred a MACE and 169 died during a median 5.8-year follow-up. HRs for MACE at the URLs were 2.3 (95% CI, 1.7-3.2) for hs-cTnI and 1.8 (95% CI, 1.3-2.4) for hs-cTnT. Corresponding HRs for mortality were 1.7 (95% CI, 1.2-2.2) for hs-cTnI and 2.3 (95 % CI, 1.7-3.1) for hs-cTnT. The HR for MACE increased with increasing hs-cTn concentration similarly for both assays, but the HR for mor...Continue Reading

References

Oct 24, 2007·Circulation·Kristian ThygesenNawwar Al-Attar
Nov 27, 2009·The New England Journal of Medicine·Torbjørn OmlandUNKNOWN Prevention of Events with Angiotensin Converting Enzyme Inhibition (PEACE) Trial Investigators
Jul 28, 2010·Circulation·Ezra A AmsterdamUNKNOWN American Heart Association Exercise, Cardiac Rehabilitation, and Prevention Committee of the Council on Clinical Cardiology,
Nov 17, 2010·JAMA : the Journal of the American Medical Association·Christopher R deFilippiStephen L Seliger
Dec 9, 2010·JAMA : the Journal of the American Medical Association·James A de LemosDarren K McGuire
Oct 4, 2011·Journal of the American College of Cardiology·Allan S JaffeFred S Apple
Aug 28, 2012·Circulation·Kristian ThygesenShanti Mendis
Feb 19, 2013·Journal of the American College of Cardiology·Torbjørn OmlandUNKNOWN PEACE Investigators
Jul 24, 2013·International Journal of Cardiology·Maria Rubini GiménezChristian Mueller
Oct 5, 2014·European Heart Journal. Acute Cardiovascular Care·Johan ThelinBertil Ohlin
Aug 13, 2015·The New England Journal of Medicine·Brendan M EverettUNKNOWN BARI 2D Study Group
May 15, 2016·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Richard BodyUNKNOWN TRAPID-AMI Investigators
Oct 28, 2017·Journal of the American College of Cardiology·Andreas RoosMartin J Holzmann
Nov 25, 2017·Clinica Chimica Acta; International Journal of Clinical Chemistry·Margot EggerThomas Mueller

❮ Previous
Next ❯

Citations

Oct 18, 2019·Diagnosis·Giuseppe LippiFabian Sanchis-Gomar
Jan 19, 2021·Cardiovascular Research·Thomas E KaierMichael Marber
Apr 19, 2021·Clinica Chimica Acta; International Journal of Clinical Chemistry·Vanda Barakett-HamadéGhassan Sleilaty
Jul 25, 2020·Journal of the American College of Cardiology·Yader SandovalAllan S Jaffe

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.