High population prevalence of cardiac troponin I measured by a high-sensitivity assay and cardiovascular risk estimation: the MORGAM Biomarker Project Scottish Cohort
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High population prevalence of cardiac troponin I measured by a high-sensitivity assay and cardiovascular risk estimation: the MORGAM Biomarker Project Scottish Cohort. / Zeller, Tanja; Tunstall-Pedoe, Hugh; Saarela, Olli; Ojeda, Francisco; Schnabel, Renate B; Tuovinen, Tarja; Woodward, Mark; Struthers, Allan; Hughes, Maria; Kee, Frank; Salomaa, Veikko; Kuulasmaa, Kari; Blankenberg, Stefan; MORGAM Investigators.
in: EUR HEART J, Jahrgang 35, Nr. 5, 02.2014, S. 271-281.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - High population prevalence of cardiac troponin I measured by a high-sensitivity assay and cardiovascular risk estimation: the MORGAM Biomarker Project Scottish Cohort
AU - Zeller, Tanja
AU - Tunstall-Pedoe, Hugh
AU - Saarela, Olli
AU - Ojeda, Francisco
AU - Schnabel, Renate B
AU - Tuovinen, Tarja
AU - Woodward, Mark
AU - Struthers, Allan
AU - Hughes, Maria
AU - Kee, Frank
AU - Salomaa, Veikko
AU - Kuulasmaa, Kari
AU - Blankenberg, Stefan
AU - MORGAM Investigators
PY - 2014/2
Y1 - 2014/2
N2 - AIMS: Our aim was to test the prediction and clinical applicability of high-sensitivity assayed troponin I for incident cardiovascular events in a general middle-aged European population.METHODS AND RESULTS: High-sensitivity assayed troponin I was measured in the Scottish Heart Health Extended Cohort (n = 15 340) with 2171 cardiovascular events (including acute coronary heart disease and probable ischaemic strokes), 714 coronary deaths (25% of all deaths), 1980 myocardial infarctions, and 797 strokes of all kinds during an average of 20 years follow-up. Detection rate above the limit of detection (LoD) was 74.8% in the overall population and 82.6% in men and 67.0% in women. Troponin I assayed by the high-sensitivity method was associated with future cardiovascular risk after full adjustment such as that individuals in the fourth category had 2.5 times the risk compared with those without detectable troponin I (P < 0.0001). These associations remained significant even for those individuals in whom levels of contemporary-sensitivity troponin I measures were not detectable. Addition of troponin I levels to clinical variables led to significant increases in risk prediction with significant improvement of the c-statistic (P < 0.0001) and net reclassification (P < 0.0001). A threshold of 4.7 pg/mL in women and 7.0 pg/mL in men is suggested to detect individuals at high risk for future cardiovascular events.CONCLUSION: Troponin I, measured with a high-sensitivity assay, is an independent predictor of cardiovascular events and might support selection of at risk individuals.
AB - AIMS: Our aim was to test the prediction and clinical applicability of high-sensitivity assayed troponin I for incident cardiovascular events in a general middle-aged European population.METHODS AND RESULTS: High-sensitivity assayed troponin I was measured in the Scottish Heart Health Extended Cohort (n = 15 340) with 2171 cardiovascular events (including acute coronary heart disease and probable ischaemic strokes), 714 coronary deaths (25% of all deaths), 1980 myocardial infarctions, and 797 strokes of all kinds during an average of 20 years follow-up. Detection rate above the limit of detection (LoD) was 74.8% in the overall population and 82.6% in men and 67.0% in women. Troponin I assayed by the high-sensitivity method was associated with future cardiovascular risk after full adjustment such as that individuals in the fourth category had 2.5 times the risk compared with those without detectable troponin I (P < 0.0001). These associations remained significant even for those individuals in whom levels of contemporary-sensitivity troponin I measures were not detectable. Addition of troponin I levels to clinical variables led to significant increases in risk prediction with significant improvement of the c-statistic (P < 0.0001) and net reclassification (P < 0.0001). A threshold of 4.7 pg/mL in women and 7.0 pg/mL in men is suggested to detect individuals at high risk for future cardiovascular events.CONCLUSION: Troponin I, measured with a high-sensitivity assay, is an independent predictor of cardiovascular events and might support selection of at risk individuals.
KW - Biomarkers/blood
KW - Cardiovascular Diseases/blood
KW - Cohort Studies
KW - Female
KW - Humans
KW - Immunoassay/methods
KW - Male
KW - Middle Aged
KW - Myocardial Infarction/blood
KW - Prevalence
KW - Risk Assessment
KW - Scotland/epidemiology
KW - Sex Distribution
KW - Stroke/blood
KW - Troponin I/blood
U2 - 10.1093/eurheartj/eht406
DO - 10.1093/eurheartj/eht406
M3 - SCORING: Journal article
C2 - 24104876
VL - 35
SP - 271
EP - 281
JO - EUR HEART J
JF - EUR HEART J
SN - 0195-668X
IS - 5
ER -