TY - JOUR

T1 - High-Sensitivity Cardiac Troponin I Levels and Prediction of Heart Failure

T2 - Results From the BiomarCaRE Consortium

AU - Yan, Isabell

AU - Börschel, Christin S.

AU - Neumann, Johannes T.

AU - Sprünker, Ngoc A.

AU - Makarova, Nataliya

AU - Kontto, Jukka

AU - Kuulasmaa, Kari

AU - Salomaa, Veikko

AU - Magnussen, Christina

AU - Iacoviello, Licia

AU - Di Castelnuovo, Augusto

AU - Costanzo, Simona

AU - Linneberg, Allan

AU - Söderberg, Stefan

AU - Zeller, Tanja

AU - Ojeda-Echevarria, Francisco M.

AU - Blankenberg, Stefan

AU - Westermann, Dirk

PY - 2020/5

Y1 - 2020/5

N2 - Objectives: The aims of this study were to characterize the association of high-sensitivity cardiac troponin I (hs-cTnI) with heart failure (HF), to determine its predictive value beyond classical cardiovascular risk factors (CVRFs) and N-terminal pro–B-type natriuretic peptide, and to derive a relevant cutoff for potential clinical application. Background: HF is an important contributor to the overall burden of cardiovascular disease. Early identification of individuals at risk could be beneficial for preventive therapies. Methods: Based on the Biomarker for Cardiovascular Risk Assessment in Europe consortium, we analyzed individual-level data from 4 prospective population-based cohort studies including 48,455 individuals. Participants with myocardial infarction, HF, and stroke at baseline were excluded. We investigated the value of adding hs-cTnI to CVRFs and N-terminal pro–B-type natriuretic peptide using Cox proportional hazards survival models and for prediction by calculating C-statistics and Brier score. Results: The median age of the study population was 51 years, and the median follow-up time for occurrence of HF was 6.61 years. Cox regression models adjusted for age, sex, and CVRFs revealed a significant association of hs-cTnI with incident HF (hazard ratio: 1.42 per log [ng/l] unit change [95% confidence interval: 1.31 to 1.53]). The best predictive value was achieved in the model with CVRFs (base model) and both biomarkers (C-index = 0.862; 95% confidence interval: 0.841 to 0.882). Optimal hs-cTnI cutoff values of 2.6 ng/l for women and 4.2 ng/l for men were derived for selecting individuals at risk. Conclusions: In this large dataset from the general population, hs-cTnI could show its independence for the prognosis of HF.

AB - Objectives: The aims of this study were to characterize the association of high-sensitivity cardiac troponin I (hs-cTnI) with heart failure (HF), to determine its predictive value beyond classical cardiovascular risk factors (CVRFs) and N-terminal pro–B-type natriuretic peptide, and to derive a relevant cutoff for potential clinical application. Background: HF is an important contributor to the overall burden of cardiovascular disease. Early identification of individuals at risk could be beneficial for preventive therapies. Methods: Based on the Biomarker for Cardiovascular Risk Assessment in Europe consortium, we analyzed individual-level data from 4 prospective population-based cohort studies including 48,455 individuals. Participants with myocardial infarction, HF, and stroke at baseline were excluded. We investigated the value of adding hs-cTnI to CVRFs and N-terminal pro–B-type natriuretic peptide using Cox proportional hazards survival models and for prediction by calculating C-statistics and Brier score. Results: The median age of the study population was 51 years, and the median follow-up time for occurrence of HF was 6.61 years. Cox regression models adjusted for age, sex, and CVRFs revealed a significant association of hs-cTnI with incident HF (hazard ratio: 1.42 per log [ng/l] unit change [95% confidence interval: 1.31 to 1.53]). The best predictive value was achieved in the model with CVRFs (base model) and both biomarkers (C-index = 0.862; 95% confidence interval: 0.841 to 0.882). Optimal hs-cTnI cutoff values of 2.6 ng/l for women and 4.2 ng/l for men were derived for selecting individuals at risk. Conclusions: In this large dataset from the general population, hs-cTnI could show its independence for the prognosis of HF.

KW - BiomarCaRE

KW - cardiovascular risk factors

KW - high-sensitivity cardiac troponin I

KW - N-terminal pro-B-type natriuretic peptide

KW - prediction of heart failure

U2 - 10.1016/j.jchf.2019.12.008

DO - 10.1016/j.jchf.2019.12.008

M3 - Journal article

C2 - 32171759

AN - SCOPUS:85083331601

VL - 8

SP - 401

EP - 411

JO - J A C C: Heart Failure

JF - J A C C: Heart Failure

SN - 2213-1779

IS - 5

ER -