Circulating Troponin as measured by a sensitive assay for cardiovascular risk assessment in primary prevention

• Verfasst von: Leistner, David [VerfasserIn]
• Verfasst von: März, Winfried [VerfasserIn]
• Titel: Circulating Troponin as measured by a sensitive assay for cardiovascular risk assessment in primary prevention
• Verf.angabe: David M. Leistner, Jens Klotsche, Lars Pieper, Günter K. Stalla, Hendrik Lehnert, Sigmund Silber, Winfried März, Hans-Ulrich Wittchen, and Andreas M. Zeiher, for the DETECT Study Group
• Jahr: 2012
• Umfang: 9 S.
• Fussnoten: Gesehen am 27.07.2018 ; Published online December 28, 2011
• Titel Quelle: Enthalten in: Clinical chemistry
• Ort Quelle: Washington, DC : American Association for Clinical Chemistry, 1955
• Jahr Quelle: 2012
• Band/Heft Quelle: 58(2012), 1, Seite 200-208
• ISSN Quelle: 1530-8561
• DOI: doi:10.1373/clinchem.2011.174292
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1578004683

Abstract

Measuring circulating cardiac troponin using novel sensitive assays has revealed that even minute elevations are associated with increased mortality in patients with coronary artery disease or even in the general population. Less well defined, however, is the incremental value of measuring circulating cardiac troponin I (cTnI) by a sensitive assay for risk assessment in primary prevention. METHODS: We measured circulating concentrations of cTnI, N-terminal pro-B-type natriuretic peptide (NT-proBNP), and high-sensitivity C-reactive protein (hsCRP) in 5388 individuals free of known cardiovascular disease recruited into the DETECT study, a prospective longitudinal population-based cohort study. We determined the prognostic implications for incident major adverse cardiovascular events (MACE) during 5 years of follow-up. RESULTS: Circulating cTnI was detectable in 19% of the subjects. Increased cTnI concentrations were associated with established risk factors for atherosclerosis and demonstrated a graded relationship with all-cause mortality and incident MACE during 5-year follow-up. A single measurement of cTnI significantly improved risk prediction over established risk factors, and also added prognostic information, when adjusted for serum concentrations of NT-proBNP and hsCRP. CONCLUSIONS: Minute increases in cTnI are associated with increased mortality and incident MACE in a large primary prevention cohort and, thus, identify contributors to cardiovascular risk not fully captured by traditional risk factor assessment.