Prevalence and pathophysiological mechanisms of elevated cardiac troponin I levels in a population-based sample of elderly subjects

被引:142
作者
Eggers, Kai M. [1 ]
Lind, Lars [2 ]
Ahlstrom, Hakan [3 ]
Bjerner, Tomas [3 ]
Barbier, Charlotte Ebeling [3 ]
Larsson, Anders [4 ]
Venge, Per [4 ]
Lindahl, Bertil [1 ]
机构
[1] Univ Uppsala Hosp, Dept Med Sci, S-75185 Uppsala, Sweden
[2] Univ Uppsala Hosp, Dept Med, S-75185 Uppsala, Sweden
[3] Univ Uppsala Hosp, Dept Radiol, S-75185 Uppsala, Sweden
[4] Univ Uppsala Hosp, Dept Clin Chem, S-75185 Uppsala, Sweden
基金
瑞典研究理事会;
关键词
cardiac troponin; cardiovascular disease; risk prediction;
D O I
10.1093/eurheartj/ehn327
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims To evaluate the prevalence of cardiac troponin I (cTnI) elevation in an elderly community population and the association of cTnI levels with cardiovascular risk factors, vascular inflammation, atherosclerosis, cardiac performance, and areas indicative of infarcted myocardium identified by cardiac magnetic resonance imaging. Methods and results cTnI elevation defined as cTnI levels > 0.01 mu g/L (Access AccuTnI, Beckman Coulter) was found in 21.8% of the study participants (n = 1005). cTnI > 0.01 mu g/L was associated with cardiovascular high-risk features, the burden of atherosclerosis in the carotid arteries, left-ventricular mass, and impaired left-ventricular systolic function. No associations were found between cTnI and inflammatory activity, diastolic dysfunction, or myocardial scars. Male gender (OR 1.6; 95% CI 1.1-2.4), ischaemic ECG changes (OR 1.7; 95% CI 1.1-2.7), and NT-pro-brain natriuretic peptide levels (OR 1.4; 95% CI 1.1-1.7) independently predicted cTnI > 0.01 mu g/L. cTnI > 0.01 mu g/L correlated also to an increased cardiovascular risk according to the Framingham risk score. Conclusion cTnI > 0.01 mu g/L is relatively common in elderly subjects and is associated with cardiovascular high-risk features and impaired cardiac performance. Cardiac troponin determined by a highly sensitive assay might thus serve as an instrument for the identification of subjects at high cardiovascular risk in general populations.
引用
收藏
页码:2252 / 2258
页数:7
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