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Serial measures of cardiac troponin T levels by a highly sensitive assay and incident atrial fibrillation in a prospective cohort of ambulatory older adults.
Wednesday,2015-04-29 09:29 America/Los_Angeles — zdrager
| Title | Serial measures of cardiac troponin T levels by a highly sensitive assay and incident atrial fibrillation in a prospective cohort of ambulatory older adults. |
| Publication Type | Journal Article |
| Year of Publication | 2015 |
| Authors | Hussein, AA, Bartz, TM, Gottdiener, JS, Sotoodehnia, N, Heckbert, SR, Lloyd-Jones, D, Kizer, JR, Christenson, R, Wazni, O, DeFilippi, C |
| Journal | Heart Rhythm |
| Volume | 12 |
| Issue | 5 |
| Pagination | 879-85 |
| Date Published | 2015 May |
| ISSN | 1556-3871 |
| Keywords | Aged, Atrial Fibrillation, Biomarkers, Electrocardiography, Female, Heart Failure, Humans, Incidence, Longitudinal Studies, Male, Outpatients, Risk Assessment, Risk Factors, Statistics as Topic, Troponin T, United States |
| Abstract | <p><b>BACKGROUND: </b>Various mechanisms in cardiac remodeling related to atrial fibrillation (AF) lead to elevated circulating cardiac troponin levels, but little is known about such elevations upstream to AF onset.</p><p><b>OBJECTIVE: </b>The purpose of this study was to study the association between circulating troponin levels as assessed by a highly sensitive cardiac troponin T (hs-cTnT) assay and incident atrial fibrillation (AF).</p><p><b>METHODS: </b>In a large prospective cohort of ambulatory older adults [the Cardiovascular Health Study (CHS)], hs-cTnT levels were measured in sera that were collected at enrollment from 4262 participants without AF (2871 with follow-up measurements). Incident AF was identified by electrocardiograms during CHS visits, hospital discharge diagnoses, and Medicare files, including outpatient and physician claims diagnoses.</p><p><b>RESULTS: </b>Over median follow-up of 11.2 years (interquartile range 6.1-16.5), 1363 participants (32.0%) developed AF. Higher baseline levels of hs-cTnT were associated with incident AF in covariate-adjusted analyses accounting for demographics, traditional risk factors, and incident heart failure in time-dependent analyzes (hazard ratio for 3rd tertile vs undetectable 1.75, 95% confidence interval 1.48-2.08). This association was statistically significant in analyses that additionally adjusted for biomarkers of inflammation and hemodynamic strain (hazard ratio for 3rd tertile vs undetectable 1.38, 95% confidence interval 1.16-1.65). Significant associations were also found when hs-cTnT levels were treated as a continuous variable and when examining change from baseline of hs-cTnT levels and incident AF.</p><p><b>CONCLUSION: </b>The findings show a significant association of circulating troponin levels in ambulatory older adults with incident AF beyond that of traditional risk factors, incident heart failure, and biomarkers of inflammation and hemodynamic strain.</p> |
| DOI | 10.1016/j.hrthm.2015.01.020 |
| Alternate Journal | Heart Rhythm |
| PubMed ID | 25602173 |
| PubMed Central ID | PMC4546831 |
| Grant List | AG023629 / AG / NIA NIH HHS / United States HHSN268200800007C / HL / NHLBI NIH HHS / United States HHSN268200800007C / / PHS HHS / United States HHSN268201200036C / HL / NHLBI NIH HHS / United States HHSN268201200036C / / PHS HHS / United States HL080295 / HL / NHLBI NIH HHS / United States HL102214 / HL / NHLBI NIH HHS / United States N01HC55222 / HC / NHLBI NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States N01HC85079 / HC / NHLBI NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States N01HC85080 / HC / NHLBI NIH HHS / United States N01HC85080 / HL / NHLBI NIH HHS / United States N01HC85081 / HC / NHLBI NIH HHS / United States N01HC85081 / HL / NHLBI NIH HHS / United States N01HC85082 / HC / NHLBI NIH HHS / United States N01HC85082 / HL / NHLBI NIH HHS / United States N01HC85083 / HC / NHLBI NIH HHS / United States N01HC85083 / HL / NHLBI NIH HHS / United States N01HC85086 / HC / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States R01 HL080295 / HL / NHLBI NIH HHS / United States R01 HL102214 / HL / NHLBI NIH HHS / United States |