Risk prediction of atrial fibrillation and its complications in the community using hs troponin I
Standard
Risk prediction of atrial fibrillation and its complications in the community using hs troponin I. / Börschel, Christin S; Geelhoed, Bastiaan; Niiranen, Teemu; Camen, Stephan; Donati, Maria Benedetta; Havulinna, Aki S; Gianfagna, Francesco; Palosaari, Tarja; Jousilahti, Pekka; Kontto, Jukka; Vartiainen, Erkki; Ojeda, Francisco M; den Ruijter, Hester M; Costanzo, Simona; de Gaetano, Giovanni; Di Castelnuovo, Augusto; Linneberg, Allan; Vishram-Nielsen, Julie K; Løchen, Maja-Lisa; Koenig, Wolfgang; Jørgensen, Torben; Kuulasmaa, Kari; Blankenberg, Stefan; Iacoviello, Licia; Zeller, Tanja; Söderberg, Stefan; Salomaa, Veikko; Schnabel, Renate B.
In: EUR J CLIN INVEST, Vol. 53, No. 5, 05.2023, p. e13950.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Risk prediction of atrial fibrillation and its complications in the community using hs troponin I
AU - Börschel, Christin S
AU - Geelhoed, Bastiaan
AU - Niiranen, Teemu
AU - Camen, Stephan
AU - Donati, Maria Benedetta
AU - Havulinna, Aki S
AU - Gianfagna, Francesco
AU - Palosaari, Tarja
AU - Jousilahti, Pekka
AU - Kontto, Jukka
AU - Vartiainen, Erkki
AU - Ojeda, Francisco M
AU - den Ruijter, Hester M
AU - Costanzo, Simona
AU - de Gaetano, Giovanni
AU - Di Castelnuovo, Augusto
AU - Linneberg, Allan
AU - Vishram-Nielsen, Julie K
AU - Løchen, Maja-Lisa
AU - Koenig, Wolfgang
AU - Jørgensen, Torben
AU - Kuulasmaa, Kari
AU - Blankenberg, Stefan
AU - Iacoviello, Licia
AU - Zeller, Tanja
AU - Söderberg, Stefan
AU - Salomaa, Veikko
AU - Schnabel, Renate B
N1 - © 2023 The Authors. European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation.
PY - 2023/5
Y1 - 2023/5
N2 - AIMS: Atrial fibrillation (AF) is becoming increasingly common. Traditional cardiovascular risk factors (CVRF) do not explain all AF cases. Blood-based biomarkers reflecting cardiac injury such as high-sensitivity troponin I (hsTnI) may help close this gap.METHODS: We investigated the predictive ability of hsTnI for incident AF in 45,298 participants (median age 51.4 years, 45.0% men) across European community cohorts in comparison to CVRF and established biomarkers (C-reactive protein, N-terminal pro B-type natriuretic peptide).RESULTS: During a median follow-up of 7.7 years, 1734 (3.8%) participants developed AF. Those in the highest hsTnI quarter (≥4.2 ng/L) had a 3.91-fold (95% confidence interval (CI) 3.30, 4.63; p < .01) risk for developing AF compared to the lowest quarter (<1.4 ng/L). In multivariable-adjusted Cox proportional hazards models a statistically significant association was seen between hsTnI and AF (hazard ratio (HR) per 1 standard deviation (SD) increase in log10(hsTnI) 1.08; 95% CI 1.01, 1.16; p = .03). Inclusion of hsTnI did improve model discrimination (C-index CVRF 0.811 vs. C-index CVRF and hsTnI 0.813; p < .01). Higher hsTnI concentrations were associated with heart failure (HR per SD 1.37; 95% CI 1.12, 1.68; p < .01) and overall mortality (HR per SD 1.24; 95% CI 1.09, 1.41; p < .01).CONCLUSION: hsTnI as a biomarker of myocardial injury does not improve prediction of AF incidence beyond classical CVRF and NT-proBNP. However, it is associated with the AF-related disease heart failure and mortality likely reflecting underlying subclinical cardiovascular impairment.
AB - AIMS: Atrial fibrillation (AF) is becoming increasingly common. Traditional cardiovascular risk factors (CVRF) do not explain all AF cases. Blood-based biomarkers reflecting cardiac injury such as high-sensitivity troponin I (hsTnI) may help close this gap.METHODS: We investigated the predictive ability of hsTnI for incident AF in 45,298 participants (median age 51.4 years, 45.0% men) across European community cohorts in comparison to CVRF and established biomarkers (C-reactive protein, N-terminal pro B-type natriuretic peptide).RESULTS: During a median follow-up of 7.7 years, 1734 (3.8%) participants developed AF. Those in the highest hsTnI quarter (≥4.2 ng/L) had a 3.91-fold (95% confidence interval (CI) 3.30, 4.63; p < .01) risk for developing AF compared to the lowest quarter (<1.4 ng/L). In multivariable-adjusted Cox proportional hazards models a statistically significant association was seen between hsTnI and AF (hazard ratio (HR) per 1 standard deviation (SD) increase in log10(hsTnI) 1.08; 95% CI 1.01, 1.16; p = .03). Inclusion of hsTnI did improve model discrimination (C-index CVRF 0.811 vs. C-index CVRF and hsTnI 0.813; p < .01). Higher hsTnI concentrations were associated with heart failure (HR per SD 1.37; 95% CI 1.12, 1.68; p < .01) and overall mortality (HR per SD 1.24; 95% CI 1.09, 1.41; p < .01).CONCLUSION: hsTnI as a biomarker of myocardial injury does not improve prediction of AF incidence beyond classical CVRF and NT-proBNP. However, it is associated with the AF-related disease heart failure and mortality likely reflecting underlying subclinical cardiovascular impairment.
KW - Male
KW - Humans
KW - Middle Aged
KW - Female
KW - Atrial Fibrillation/epidemiology
KW - Troponin I
KW - Risk Factors
KW - Biomarkers
KW - Heart Failure/epidemiology
KW - Natriuretic Peptide, Brain
KW - Peptide Fragments
U2 - 10.1111/eci.13950
DO - 10.1111/eci.13950
M3 - SCORING: Journal article
C2 - 36602448
VL - 53
SP - e13950
JO - EUR J CLIN INVEST
JF - EUR J CLIN INVEST
SN - 0014-2972
IS - 5
ER -
