Prognostic Value of Cardiac Troponin I Measured With a Highly Sensitive Assay in Patients With Stable Coronary Artery Disease

被引：274

作者：

Omland, Torbjorn ^{[1
,2
,3
]}

Pfeffer, Marc A. ^{[4
,5
]}

Solomon, Scott D. ^{[4
,5
]}

de Lemos, James A. ^{[6
]}

Rosjo, Helge ^{[1
,2
,3
]}

Benth, Jurate Saltyte ^{[7
,8
]}

Maggioni, Aldo ^{[9
]}

Domanski, Michael J. ^{[10
]}

Rouleau, Jean L. ^{[11
,12
]}

Sabatine, Marc S. ^{[4
,5
]}

Braunwald, Eugene ^{[4
,5
]}

机构：

[1] Akershus Univ Hosp, Div Med, Dept Cardiol, NO-1478 Lorenskog, Norway

[2] Univ Oslo, Ctr Heart Failure Res, Oslo, Norway

[3] Univ Oslo, KG Jebsen Cardiac Res Ctr, Oslo, Norway

[4] Harvard Univ, Sch Med, Dept Med, Boston, MA USA

[5] Brigham & Womens Hosp, Div Cardiovasc, Boston, MA 02115 USA

[6] Univ Texas SW Med Ctr Dallas, Div Cardiol, Dallas, TX 75390 USA

[7] Akershus Univ Hosp, HOKH Res Ctr, NO-1478 Lorenskog, Norway

[8] Univ Oslo, Inst Clin Med, Oslo, Norway

[9] Ctr Studi ANMCO, Florence, Italy

[10] Mt Sinai Sch Med, New York, NY USA

[11] Montreal Heart Inst, Montreal, PQ H1T 1C8, Canada

[12] Univ Montreal, Fac Med, Montreal, PQ H3C 3J7, Canada

来源：

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | 2013年 / 61卷 / 12期

关键词：

cardiovascular death; coronary artery disease; natriuretic peptides; troponin; MYOCARDIAL-ISCHEMIA; HEART-FAILURE; T ASSAY; MORTALITY; RISK; ASSOCIATION; RELEASE; SERUM;

D O I：

10.1016/j.jacc.2012.12.026

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives The aims of this study were to assess the prognostic value of cardiac troponin I levels, measured with a new high-sensitivity assay, in low-risk patients with stable coronary artery disease (CAD) and to contrast its determinants and prognostic merit with that of high-sensitivity cardiac troponin T (hs-TnT). Background New, highly sensitive cardiac troponin assays permit evaluation of the association between troponin levels and outcomes in patients with stable CAD. Methods High-sensitivity cardiac troponin I (hs-TnI) levels at baseline were assessed in 3,623 patients with stable CAD and preserved systolic function enrolled in the PEACE (Prevention of Events With Angiotensin-Converting Enzyme Inhibitor Therapy) trial. Results In total, 98.5% of patients had hs-TnI concentrations higher than the detection level (1.2 pg/ml). hs-TnI correlated moderately with hs-TnT (r = 0.44) and N-terminal pro-B-type natriuretic peptide (r = 0.39) but only weakly with age (r = 0.17) and estimated glomerular filtration rate (r = -0.11). During a median follow-up period of 5.2 years, 203 patients died of cardiovascular causes or were hospitalized for heart failure, and 209 patients had nonfatal myocardial infarctions. In analyses adjusting for conventional risk markers, N-terminal pro-B-type natriuretic peptide, and hs-TnT, hs-TnI levels in the fourth compared with the 3 lower quartiles were associated with the incidence of cardiovascular death or heart failure (hazard ratio: 1.88; 95% confidence interval: 1.33 to 2.66; p < 0.001). There was a significant, albeit weaker association with nonfatal myocardial infarction (hazard ratio: 1.44; 95% confidence interval: 1.03 to 2.01; p = 0.031). In the same models, hs-TnT concentrations were associated with the incidence of cardiovascular death or heart failure but not of myocardial infarction. Conclusions In patients with stable CAD, hs-TnI concentrations are associated with cardiovascular risk independently of conventional risk markers and hs-TnT. (Prevention of Events With Angiotensin-Converting Enzyme Inhibitor Therapy [PEACE]; NCT00000558) (J Am Coll Cardiol 2013;61:1240-9) (C) 2013 by the American College of Cardiology Foundation

引用

页码：1240 / 1249

页数：10

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